Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $95.50 / $190.55	Facility		$66.07	$95.50	$190.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $63.10 / $109.65	Professional		$63.10	$63.10	$109.65
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $79.43 / $141.25	Facility		$79.43	$79.43	$141.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $64.57 / $81.28	Professional		$64.57	$64.57	$81.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $74.13 / $162.18	Facility		$64.57	$74.13	$162.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $81.28 / $117.49	Professional		$64.57	$81.28	$117.49
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $63.10 / $141.25	Facility		$41.69	$63.10	$141.25
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $128.82 / $128.82	Professional		$95.50	$128.82	$128.82
Medica Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $63.10 / $138.04	Facility		$41.69	$63.10	$138.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $69.18 / $128.82	Professional		$63.10	$69.18	$128.82
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 $64.57 / $64.57 / $190.55	Professional		$64.57	$64.57	$190.55
Quartz Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $64.57 / $316.23	Facility		$64.57	$64.57	$316.23
Quartz Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $64.57 / $64.57	Professional		$64.57	$64.57	$64.57
Security Health Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $107.15	Professional		$87.10	$87.10	$107.15
United Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $57.54 / $64.57	Facility		$57.54	$57.54	$64.57
United Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $70.79 / $95.50	Professional		$64.57	$70.79	$95.50