Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $575.44 / $575.44	Facility		$575.44	$575.44	$575.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $575.44 / $588.84	Professional		$407.38	$575.44	$588.84
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $1,621.81 / $1,621.81	Facility		$891.25	$1,621.81	$1,621.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $891.25 / $1,122.02	Professional		$478.63	$891.25	$1,122.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $234.42 / $3,890.45	Facility		$234.42	$234.42	$3,890.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $977.24 / $1,737.80	Professional		$234.42	$977.24	$1,737.80
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $239.88 / $831.76	Facility		$79.43	$239.88	$831.76
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $338.84 / $338.84	Professional		$338.84	$338.84	$338.84
Medica Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $575.44 / $3,890.45	Facility		$52.48	$575.44	$3,890.45
Medica Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $407.38 / $660.69	Professional		$281.84	$407.38	$660.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $58.88 / $89.13	Professional		$32.36	$58.88	$89.13
Quartz Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $169.82 / $223.87	Professional		$100.00	$169.82	$223.87
Quartz Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $1,380.38 / $4,073.80	Facility		$234.42	$1,380.38	$4,073.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $234.42 / $234.42	Professional		$60.26	$234.42	$234.42
United Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $295.12 / $575.44	Facility		$35.48	$295.12	$575.44
United Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $371.54 / $707.95	Professional		$275.42	$371.54	$707.95