Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $66.07 / $66.07	Facility		$66.07	$66.07	$66.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $67.61 / $83.18	Professional		$57.54	$67.61	$83.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $229.09 / $363.08	Facility		$173.78	$229.09	$363.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $81.28 / $144.54	Professional		$69.18	$81.28	$144.54
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $79.43 / $141.25	Facility		$63.10	$79.43	$141.25
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $158.49 / $218.78	Professional		$112.20	$158.49	$218.78
Medica Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $81.28 / $158.49	Facility		$61.66	$81.28	$158.49
Medica Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $123.03 / $489.78	Professional		$77.62	$123.03	$489.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $70.79	Professional		$32.36	$33.11	$70.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $173.78 / $251.19	Professional		$85.11	$173.78	$251.19
Quartz Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $144.54 / $489.78	Facility		$144.54	$144.54	$489.78
Quartz Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $162.18 / $489.78	Professional		$69.18	$162.18	$489.78
Security Health Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $91.20 / $91.20	Professional		$91.20	$91.20	$91.20
Security Health Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $158.49 / $158.49	Professional		$102.33	$158.49	$158.49
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $107.15 / $181.97	Professional		$74.13	$107.15	$181.97