Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $295.12 / $645.65	Facility		$295.12	$295.12	$645.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $302.00 / $363.08	Professional		$295.12	$302.00	$363.08
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $602.56 / $616.60	Facility		$512.86	$602.56	$616.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $575.44 / $1,288.25	Professional		$338.84	$575.44	$1,288.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $204.17 / $309.03	Facility		$100.00	$204.17	$309.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $616.60 / $707.95	Professional		$309.03	$616.60	$707.95
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $891.25 / $1,230.27	Facility		$302.00	$891.25	$1,230.27
Medica Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $309.03 / $478.63	Facility		$177.83	$309.03	$478.63
Medica Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $302.00 / $1,380.38	Professional		$302.00	$302.00	$1,380.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $58.88 / $275.42	Professional		$32.36	$58.88	$275.42
Quartz Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $1,023.29 / $1,412.54	Professional		$478.63	$1,023.29	$1,412.54
Quartz Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $309.03 / $1,096.48	Facility		$309.03	$309.03	$1,096.48
Quartz Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $389.05 / $1,659.59	Professional		$309.03	$389.05	$1,659.59
United Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $177.83 / $275.42	Facility		$177.83	$177.83	$275.42
United Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $302.00 / $416.87	Professional		$302.00	$302.00	$416.87