Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $61.66 / $61.66	Facility		$61.66	$61.66	$61.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $61.66 / $69.18	Professional		$44.67	$61.66	$69.18
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $169.82 / $169.82	Facility		$93.33	$169.82	$169.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $93.33 / $114.82	Professional		$77.62	$93.33	$114.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $63.10 / $371.54	Facility		$43.65	$63.10	$371.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $112.20 / $177.83	Professional		$43.65	$112.20	$177.83
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $64.57 / $114.82	Facility		$30.20	$64.57	$114.82
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $53.70 / $53.70	Professional		$53.70	$53.70	$53.70
Medica Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $109.65 / $398.11	Facility		$30.20	$109.65	$398.11
Medica Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $51.29 / $91.20	Professional		$39.81	$51.29	$91.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $54.95 / $89.13	Professional		$40.74	$54.95	$89.13
Quartz Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $19.05 / $25.12	Professional		$12.30	$19.05	$25.12
Quartz Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $181.97 / $407.38	Facility		$43.65	$181.97	$407.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $43.65 / $69.18	Professional		$43.65	$43.65	$69.18
United Facility/Professional Facility Modifier Low / Median / High Price $4.68 / $37.15 / $61.66	Facility		$4.68	$37.15	$61.66
United Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $50.12 / $100.00	Professional		$31.62	$50.12	$100.00