Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $154.88 / $154.88	Facility		$151.36	$154.88	$154.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $158.49 / $218.78	Professional		$151.36	$158.49	$218.78
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $354.81 / $371.54	Facility		$309.03	$354.81	$371.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $158.49 / $158.49	Professional		$158.49	$158.49	$158.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $190.55 / $380.19	Facility		$158.49	$190.55	$380.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $177.83 / $204.17	Professional		$158.49	$177.83	$204.17
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $165.96 / $190.55	Facility		$154.88	$165.96	$190.55
Medica Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $190.55 / $190.55	Facility		$154.88	$190.55	$190.55
Medica Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $158.49 / $208.93	Professional		$158.49	$158.49	$208.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $85.11	Professional		$85.11	$85.11	$85.11
Quartz Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $190.55 / $831.76	Facility		$162.18	$190.55	$831.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Professional		$162.18	$162.18	$162.18
United Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $190.55 / $190.55	Facility		$165.96	$190.55	$190.55
United Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $158.49 / $218.78	Professional		$158.49	$158.49	$218.78