Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $89.13 / $89.13	Facility		$89.13	$89.13	$89.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $89.13 / $104.71	Professional		$72.44	$89.13	$104.71
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $251.19 / $251.19	Facility		$138.04	$251.19	$251.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $138.04 / $169.82	Professional		$117.49	$138.04	$169.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $57.54 / $549.54	Facility		$57.54	$57.54	$549.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $165.96 / $263.03	Professional		$57.54	$165.96	$263.03
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $89.13 / $162.18	Facility		$42.66	$89.13	$162.18
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Professional		$75.86	$75.86	$75.86
Medica Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $134.90 / $645.65	Facility		$42.66	$134.90	$645.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $77.62 / $128.82	Professional		$56.23	$77.62	$128.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $58.88 / $89.13	Professional		$47.86	$58.88	$89.13
Quartz Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $30.90 / $41.69	Professional		$18.20	$30.90	$41.69
Quartz Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $269.15 / $691.83	Facility		$57.54	$269.15	$691.83
Quartz Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $57.54 / $102.33	Professional		$57.54	$57.54	$102.33
United Facility/Professional Facility Modifier Low / Median / High Price $6.31 / $56.23 / $97.72	Facility		$6.31	$56.23	$97.72
United Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $72.44 / $138.04	Professional		$52.48	$72.44	$138.04