Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $131.83 / $131.83	Facility		$61.66	$131.83	$131.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $72.44 / $169.82	Professional		$56.23	$72.44	$169.82
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $66.07 / $120.23 / $194.98	Professional	25	$66.07	$120.23	$194.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $93.33 / $186.21	Professional		$67.61	$93.33	$186.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $218.78 / $346.74	Facility		$165.96	$218.78	$346.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $131.83 / $204.17	Professional		$67.61	$131.83	$204.17
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $72.44 / $134.90	Facility		$56.23	$72.44	$134.90
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $147.91 / $199.53	Professional		$104.71	$147.91	$199.53
Medica Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $74.13 / $144.54	Facility		$56.23	$74.13	$144.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $125.89 / $457.09	Professional		$72.44	$125.89	$457.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $70.79	Professional		$32.36	$33.11	$70.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $151.36 / $229.09	Professional		$87.10	$151.36	$229.09
Quartz Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $131.83 / $446.68	Facility		$131.83	$131.83	$446.68
Quartz Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $131.83 / $457.09	Professional		$63.10	$131.83	$457.09
Security Health Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $125.89 / $147.91	Professional		$87.10	$125.89	$147.91
United Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $97.72 / $169.82	Professional		$69.18	$97.72	$169.82