Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $97.72 / $97.72	Facility		$97.72	$97.72	$97.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $97.72 / $112.20	Professional		$63.10	$97.72	$112.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $263.03 / $263.03	Facility		$144.54	$263.03	$263.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $144.54 / $177.83	Professional		$120.23	$144.54	$177.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $112.20 / $562.34	Facility		$91.20	$112.20	$562.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $169.82 / $275.42	Professional		$91.20	$169.82	$275.42
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $144.54 / $194.98	Facility		$97.72	$144.54	$194.98
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Professional		$112.20	$112.20	$112.20
Medica Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $173.78 / $645.65	Facility		$97.72	$173.78	$645.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $93.33 / $154.88	Professional		$69.18	$93.33	$154.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $8.13 / $54.95 / $125.89	Professional		$8.13	$54.95	$125.89
Quartz Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $30.90 / $40.74	Professional		$19.05	$30.90	$40.74
Quartz Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $281.84 / $645.65	Facility		$91.20	$281.84	$645.65
Quartz Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $91.20 / $117.49	Professional		$91.20	$91.20	$117.49
United Facility/Professional Facility Modifier Low / Median / High Price $7.94 / $63.10 / $100.00	Facility		$7.94	$63.10	$100.00
United Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $91.20 / $162.18	Professional		$57.54	$91.20	$162.18