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 / $97.72	Professional		$75.86	$75.86	$97.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $165.96 / $288.40	Facility		$75.86	$165.96	$288.40
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 $79.43 / $79.43 / $173.78	Facility		$79.43	$79.43	$173.78
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $158.49 / $158.49	Professional		$117.49	$158.49	$158.49
Medica Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $77.62 / $173.78	Facility		$77.62	$77.62	$173.78
Medica Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $125.89	Professional		$77.62	$77.62	$125.89
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 Professional Modifier Low / Median / High Price $75.86 / $87.10 / $245.47	Professional		$75.86	$87.10	$245.47
Quartz Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $75.86 / $398.11	Facility		$75.86	$75.86	$398.11
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 $102.33 / $102.33 / $125.89	Professional		$102.33	$102.33	$125.89
United Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $79.43 / $79.43	Facility		$79.43	$79.43	$79.43
United Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $104.71	Professional		$75.86	$75.86	$104.71