Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $309.03 / $616.60	Facility		$213.80	$309.03	$616.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $208.93 / $354.81	Professional		$208.93	$208.93	$354.81
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $257.04 / $467.74	Facility		$257.04	$257.04	$467.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $208.93 / $263.03	Professional		$208.93	$208.93	$263.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $218.78 / $489.78	Facility		$208.93	$218.78	$489.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $263.03 / $380.19	Professional		$208.93	$263.03	$380.19
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $208.93 / $457.09	Facility		$151.36	$208.93	$457.09
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $416.87 / $416.87	Professional		$309.03	$416.87	$416.87
Medica Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $208.93 / $457.09	Facility		$151.36	$208.93	$457.09
Medica Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $208.93 / $331.13	Professional		$208.93	$208.93	$331.13
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 $208.93 / $208.93 / $616.60	Professional		$208.93	$208.93	$616.60
Quartz Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $208.93 / $1,023.29	Facility		$194.98	$208.93	$1,023.29
Quartz Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $208.93 / $208.93	Professional		$208.93	$208.93	$208.93
Security Health Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $281.84 / $346.74	Professional		$208.93	$281.84	$346.74
United Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $199.53 / $208.93	Facility		$199.53	$199.53	$208.93
United Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $208.93 / $281.84	Professional		$208.93	$208.93	$281.84