Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Facility		$75.86	$75.86	$75.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $75.86 / $87.10	Professional		$52.48	$75.86	$87.10
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $204.17 / $204.17	Facility		$112.20	$204.17	$204.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $112.20 / $141.25	Professional		$95.50	$112.20	$141.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $81.28 / $467.74	Facility		$72.44	$81.28	$467.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $141.25 / $213.80	Professional		$72.44	$141.25	$213.80
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $109.65 / $158.49	Facility		$37.15	$109.65	$158.49
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $66.07 / $66.07	Professional		$66.07	$66.07	$66.07
Medica Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $138.04 / $524.81	Facility		$37.15	$138.04	$524.81
Medica Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $64.57 / $120.23	Professional		$48.98	$64.57	$120.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $58.88 / $89.13	Professional		$44.67	$58.88	$89.13
Quartz Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $24.55 / $32.36	Professional		$14.79	$24.55	$32.36
Quartz Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $223.87 / $524.81	Facility		$72.44	$223.87	$524.81
Quartz Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $72.44 / $89.13	Professional		$61.66	$72.44	$89.13
United Facility/Professional Facility Modifier Low / Median / High Price $5.75 / $45.71 / $77.62	Facility		$5.75	$45.71	$77.62
United Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $63.10 / $128.82	Professional		$40.74	$63.10	$128.82