Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $114.82 / $229.09	Facility		$77.62	$114.82	$229.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $131.83	Professional		$75.86	$75.86	$131.83
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $95.50 / $169.82	Facility		$95.50	$95.50	$169.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $95.50	Professional		$75.86	$75.86	$95.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $89.13 / $190.55	Facility		$75.86	$89.13	$190.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $97.72 / $141.25	Professional		$77.62	$97.72	$141.25
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $75.86 / $165.96	Facility		$44.67	$75.86	$165.96
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $151.36 / $151.36	Professional		$114.82	$151.36	$151.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $75.86 / $165.96	Facility		$44.67	$75.86	$165.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $120.23	Professional		$75.86	$75.86	$120.23
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 $75.86 / $83.18 / $229.09	Professional		$75.86	$83.18	$229.09
Quartz Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $75.86 / $380.19	Facility		$75.86	$75.86	$380.19
Quartz Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Professional		$75.86	$75.86	$75.86
Security Health Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $102.33 / $125.89	Professional		$61.66	$102.33	$125.89
United Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $72.44 / $75.86	Facility		$72.44	$72.44	$75.86
United Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $107.15	Professional		$75.86	$75.86	$107.15