Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $177.83 / $177.83	Facility		$177.83	$177.83	$177.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $181.97 / $186.21	Professional		$177.83	$181.97	$186.21
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $309.03 / $316.23	Facility		$263.03	$309.03	$316.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $165.96 / $251.19	Professional		$162.18	$165.96	$251.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $186.21 / $371.54	Facility		$85.11	$186.21	$371.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $186.21 / $186.21	Professional		$186.21	$186.21	$186.21
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $177.83 / $269.15	Facility		$177.83	$177.83	$269.15
Medica Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $186.21 / $794.33	Facility		$177.83	$186.21	$794.33
Medica Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $794.33 / $794.33	Professional		$794.33	$794.33	$794.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $64.57 / $70.79	Professional		$54.95	$64.57	$70.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5,888.44 / $5,888.44 / $5,888.44	Professional		$5,888.44	$5,888.44	$5,888.44
Quartz Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $562.34 / $776.25	Facility		$229.09	$562.34	$776.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $186.21 / $1,000.00	Professional		$186.21	$186.21	$1,000.00
United Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $131.83 / $141.25	Facility		$131.83	$131.83	$141.25