Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $12.37 / $175.98 / $189.94	Facility		$12.37	$175.98	$189.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.37 / $14.58 / $17.10	Professional		$12.37	$14.58	$17.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.39 / $41.16 / $80.15	Professional		$21.39	$41.16	$80.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $17.32 / $84.99 / $134.08	Facility		$17.32	$84.99	$134.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $17.32 / $38.29 / $43.51	Professional		$17.32	$38.29	$43.51
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $12.37 / $17.10 / $24.96	Facility		$12.37	$17.10	$24.96
Medica Facility/Professional Facility Modifier Low / Median / High Price $12.37 / $20.87 / $1,335.60	Facility		$12.37	$20.87	$1,335.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $20.38 / $20.38 / $32.61	Professional		$20.38	$20.38	$32.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $85.00	Professional		$50.00	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $12.37 / $17.10 / $24.96	Facility		$12.37	$17.10	$24.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $22.66 / $49.69 / $69.30	Professional		$22.66	$49.69	$69.30
Quartz Facility/Professional Facility Modifier Low / Median / High Price $111.49 / $111.49 / $111.49	Facility		$111.49	$111.49	$111.49
Quartz Facility/Professional Professional Modifier Low / Median / High Price $17.32 / $107.90 / $136.72	Professional		$17.32	$107.90	$136.72
United Facility/Professional Professional Modifier Low / Median / High Price $20.38 / $20.38 / $26.49	Professional		$20.38	$20.38	$26.49