Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $66.07 / $66.07	Facility		$66.07	$66.07	$66.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $66.07 / $77.62	Professional		$46.77	$66.07	$77.62
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $173.78 / $173.78	Facility		$95.50	$173.78	$173.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $95.50 / $120.23	Professional		$89.13	$95.50	$120.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $81.28 / $389.05	Facility		$60.26	$81.28	$389.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $117.49 / $181.97	Professional		$60.26	$117.49	$181.97
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $100.00 / $144.54	Facility		$54.95	$100.00	$144.54
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $83.18 / $83.18	Professional		$83.18	$83.18	$83.18
Medica Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $120.23 / $436.52	Facility		$54.95	$120.23	$436.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $67.61 / $112.20	Professional		$44.67	$67.61	$112.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $63.10 / $104.71	Professional		$50.12	$63.10	$104.71
Quartz Facility/Professional Professional Modifier Low / Median / High Price $12.59 / $19.50 / $26.30	Professional		$12.59	$19.50	$26.30
Quartz Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $186.21 / $436.52	Facility		$60.26	$186.21	$436.52
Quartz Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $60.26 / $79.43	Professional		$60.26	$60.26	$79.43
United Facility/Professional Facility Modifier Low / Median / High Price $5.25 / $41.69 / $66.07	Facility		$5.25	$41.69	$66.07
United Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $66.07 / $114.82	Professional		$41.69	$66.07	$114.82