Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $741.31 / $1,659.59	Facility		$741.31	$741.31	$1,659.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $758.58 / $1,071.52	Professional		$741.31	$758.58	$1,071.52
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,479.11 / $1,737.80 / $1,778.28	Facility		$1,479.11	$1,737.80	$1,778.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $776.25 / $776.25	Professional		$776.25	$776.25	$776.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $794.33 / $794.33	Facility		$794.33	$794.33	$794.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $794.33 / $794.33	Professional		$794.33	$794.33	$794.33
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $741.31 / $741.31	Facility		$741.31	$741.31	$741.31
Medica Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $741.31 / $741.31	Facility		$741.31	$741.31	$741.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $85.11	Professional		$85.11	$85.11	$85.11
Quartz Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $794.33 / $3,890.45	Facility		$794.33	$794.33	$3,890.45
Quartz Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $794.33 / $794.33	Professional		$794.33	$794.33	$794.33
United Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $794.33 / $794.33	Facility		$794.33	$794.33	$794.33