Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $57.54 / $57.54	Facility		$57.54	$57.54	$57.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $57.54 / $67.61	Professional		$40.74	$57.54	$67.61
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $165.96 / $165.96	Facility		$91.20	$165.96	$165.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $91.20 / $112.20	Professional		$77.62	$91.20	$112.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $61.66 / $363.08	Facility		$44.67	$61.66	$363.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $109.65 / $173.78	Professional		$44.67	$109.65	$173.78
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $58.88 / $104.71	Facility		$25.12	$58.88	$104.71
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $52.48 / $52.48	Professional		$52.48	$52.48	$52.48
Medica Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $91.20 / $407.38	Facility		$25.12	$91.20	$407.38
Medica Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $50.12 / $91.20	Professional		$36.31	$50.12	$91.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $53.70 / $89.13	Professional		$32.36	$53.70	$89.13
Quartz Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $19.05 / $26.30	Professional		$12.02	$19.05	$26.30
Quartz Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $177.83 / $407.38	Facility		$44.67	$177.83	$407.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $44.67 / $67.61	Professional		$44.67	$44.67	$67.61
United Facility/Professional Facility Modifier Low / Median / High Price $4.07 / $35.48 / $61.66	Facility		$4.07	$35.48	$61.66
United Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $45.71 / $93.33	Professional		$31.62	$45.71	$93.33