Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $120.23 / $120.23	Facility		$120.23	$120.23	$120.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $120.23 / $165.96	Professional		$89.13	$120.23	$165.96
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $295.12 / $295.12	Facility		$162.18	$295.12	$295.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $162.18 / $204.17	Professional		$128.82	$162.18	$204.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $112.20 / $660.69	Facility		$109.65	$112.20	$660.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $204.17 / $316.23	Professional		$109.65	$204.17	$316.23
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $120.23 / $204.17	Facility		$25.12	$120.23	$204.17
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $165.96 / $165.96	Professional		$165.96	$165.96	$165.96
Medica Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $186.21 / $794.33	Facility		$25.12	$186.21	$794.33
Medica Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $128.82 / $208.93	Professional		$69.18	$128.82	$208.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $15.85 / $89.13	Professional		$8.91	$15.85	$89.13
Quartz Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $34.67 / $44.67	Professional		$18.20	$34.67	$44.67
Quartz Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $281.84 / $831.76	Facility		$109.65	$281.84	$831.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $109.65 / $112.20	Professional		$13.18	$109.65	$112.20
United Facility/Professional Facility Modifier Low / Median / High Price $10.23 / $83.18 / $128.82	Facility		$10.23	$83.18	$128.82
United Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $117.49 / $208.93	Professional		$69.18	$117.49	$208.93