Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $251.19 / $501.19	Facility		$173.78	$251.19	$501.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $169.82 / $288.40	Professional		$169.82	$169.82	$288.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $208.93 / $380.19	Facility		$208.93	$208.93	$380.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $169.82 / $213.80	Professional		$169.82	$169.82	$213.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $239.88 / $436.52	Facility		$169.82	$239.88	$436.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $213.80 / $309.03	Professional		$173.78	$213.80	$309.03
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $165.96 / $363.08	Facility		$165.96	$165.96	$363.08
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $331.13 / $331.13	Professional		$251.19	$331.13	$331.13
Medica Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $354.81	Facility		$162.18	$162.18	$354.81
Medica Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $257.04	Professional		$162.18	$162.18	$257.04
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 $169.82 / $181.97 / $537.03	Professional		$169.82	$181.97	$537.03
Quartz Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $169.82 / $831.76	Facility		$169.82	$169.82	$831.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $169.82 / $169.82	Professional		$169.82	$169.82	$169.82
Security Health Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $234.42 / $288.40	Professional		$234.42	$234.42	$288.40
United Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $169.82	Facility		$162.18	$162.18	$169.82
United Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $169.82 / $229.09	Professional		$169.82	$169.82	$229.09