Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $104.71 / $104.71	Facility		$104.71	$104.71	$104.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $107.15 / $112.20	Professional		$104.71	$107.15	$112.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $69.18 / $91.20	Professional		$28.18	$69.18	$91.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Facility		$112.20	$112.20	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Professional		$112.20	$112.20	$112.20
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $107.15 / $162.18	Facility		$104.71	$107.15	$162.18
Medica Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $112.20 / $190.55	Facility		$104.71	$112.20	$190.55
Medica Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $489.78 / $489.78	Professional		$489.78	$489.78	$489.78
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 $112.20 / $112.20 / $398.11	Facility		$112.20	$112.20	$398.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $588.84	Professional		$112.20	$112.20	$588.84