Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $20.89 / $20.89 / $20.89	Facility		$20.89	$20.89	$20.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $20.89 / $26.30	Professional		$20.89	$20.89	$26.30
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $1,000.00 / $1,047.13	Facility		$870.96	$1,000.00	$1,047.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $363.08 / $741.31	Professional		$213.80	$363.08	$741.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $660.69 / $1,071.52	Facility		$181.97	$660.69	$1,071.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $302.00 / $446.68	Professional		$181.97	$302.00	$446.68
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $20.89 / $22.39 / $251.19	Facility		$20.89	$22.39	$251.19
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $173.78	Professional		$173.78	$173.78	$173.78
Medica Facility/Professional Facility Modifier Low / Median / High Price $20.89 / $22.39 / $251.19	Facility		$20.89	$22.39	$251.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $194.98 / $1,380.38	Professional		$128.82	$194.98	$1,380.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $54.95 / $85.11	Professional		$50.12	$54.95	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $501.19 / $691.83	Professional		$331.13	$501.19	$691.83
Quartz Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $181.97 / $1,380.38	Facility		$181.97	$181.97	$1,380.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $1,096.48 / $1,380.38	Professional		$181.97	$1,096.48	$1,380.38
United Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $204.17 / $467.74	Facility		$204.17	$204.17	$467.74
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $138.04 / $263.03	Professional		$87.10	$138.04	$263.03