Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $346.74 / $691.83	Facility		$239.88	$346.74	$691.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $229.09 / $457.09	Professional		$229.09	$229.09	$457.09
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $288.40 / $512.86	Facility		$288.40	$288.40	$512.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $229.09 / $295.12	Professional		$229.09	$229.09	$295.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $239.88 / $549.54	Facility		$229.09	$239.88	$549.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $295.12 / $426.58	Professional		$234.42	$295.12	$426.58
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $229.09 / $229.09	Facility		$141.25	$229.09	$229.09
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $457.09 / $457.09	Professional		$89.13	$457.09	$457.09
Medica Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $229.09 / $229.09	Facility		$141.25	$229.09	$229.09
Medica Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $229.09 / $371.54	Professional		$229.09	$229.09	$371.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $64.57 / $85.11	Professional		$64.57	$64.57	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $229.09 / $691.83	Professional		$229.09	$229.09	$691.83
Quartz Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $229.09 / $1,148.15	Facility		$218.78	$229.09	$1,148.15
Quartz Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $229.09 / $229.09	Professional		$229.09	$229.09	$229.09
Security Health Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $309.03 / $380.19	Professional		$223.87	$309.03	$380.19
United Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $223.87 / $229.09	Facility		$223.87	$223.87	$229.09
United Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $229.09 / $316.23	Professional		$229.09	$229.09	$316.23