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 $81.28 / $120.23 / $141.25	Professional		$81.28	$120.23	$141.25
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $323.59 / $323.59	Facility		$177.83	$323.59	$323.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $177.83 / $218.78	Professional		$147.91	$177.83	$218.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $144.54 / $676.08	Facility		$114.82	$144.54	$676.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $208.93 / $338.84	Professional		$114.82	$208.93	$338.84
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $169.82 / $245.47	Facility		$64.57	$169.82	$245.47
Medica Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $218.78 / $776.25	Facility		$102.33	$218.78	$776.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $104.71 / $181.97	Professional		$77.62	$104.71	$181.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $58.88 / $89.13	Professional		$48.98	$58.88	$89.13
Quartz Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $37.15 / $48.98	Professional		$23.44	$37.15	$48.98
Quartz Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $346.74 / $776.25	Facility		$64.57	$346.74	$776.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $114.82 / $134.90	Professional		$97.72	$114.82	$134.90
United Facility/Professional Facility Modifier Low / Median / High Price $9.33 / $72.44 / $117.49	Facility		$9.33	$72.44	$117.49
United Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $100.00 / $204.17	Professional		$63.10	$100.00	$204.17