Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $141.25 / $141.25	Facility		$141.25	$141.25	$141.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $141.25 / $173.78	Professional		$109.65	$141.25	$173.78
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $398.11 / $398.11	Facility		$218.78	$398.11	$398.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $218.78 / $288.40	Professional		$177.83	$218.78	$288.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $134.90 / $912.01	Facility		$134.90	$134.90	$912.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $309.03 / $416.87	Professional		$134.90	$309.03	$416.87
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $141.25 / $257.04	Facility		$60.26	$141.25	$257.04
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $125.89	Professional		$125.89	$125.89	$125.89
Medica Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $245.47 / $1,000.00	Facility		$60.26	$245.47	$1,000.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $109.65 / $204.17	Professional		$85.11	$109.65	$204.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $64.57 / $120.23	Professional		$50.12	$64.57	$120.23
Quartz Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $42.66 / $57.54	Professional		$28.84	$42.66	$57.54
Quartz Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $436.52 / $1,047.13	Facility		$134.90	$436.52	$1,047.13
Quartz Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $134.90 / $154.88	Professional		$114.82	$134.90	$154.88
United Facility/Professional Facility Modifier Low / Median / High Price $8.71 / $79.43 / $144.54	Facility		$8.71	$79.43	$144.54
United Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $107.15 / $218.78	Professional		$72.44	$107.15	$218.78