Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $113.28 / $113.28 / $252.61	Facility		$113.28	$113.28	$252.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.28 / $113.28 / $141.60	Professional		$113.28	$113.28	$141.60
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $179.28 / $208.36 / $216.11	Facility		$179.28	$208.36	$216.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $118.00 / $118.00 / $120.36	Professional		$118.00	$118.00	$120.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.36 / $274.30 / $392.10	Facility		$120.36	$274.30	$392.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $115.13 / $118.58 / $143.91	Professional		$115.13	$118.58	$143.91
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $113.28 / $141.60 / $141.60	Facility		$113.28	$141.60	$141.60
Medica Facility/Professional Facility Modifier Low / Median / High Price $97.42 / $181.09 / $269.04	Facility		$97.42	$181.09	$269.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $118.00 / $118.00 / $153.40	Professional		$118.00	$118.00	$153.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $85.00 / $435.53	Professional		$50.00	$85.00	$435.53
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $113.28 / $141.60 / $141.60	Facility		$113.28	$141.60	$141.60
Quartz Facility/Professional Facility Modifier Low / Median / High Price $531.00 / $531.00 / $531.00	Facility		$531.00	$531.00	$531.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $120.36 / $120.36 / $120.36	Professional		$120.36	$120.36	$120.36
United Facility/Professional Professional Modifier Low / Median / High Price $118.00 / $118.00 / $153.40	Professional		$118.00	$118.00	$153.40