Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $323.59 / $645.65	Facility		$218.78	$323.59	$645.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $213.80 / $363.08	Professional		$213.80	$213.80	$363.08
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $269.15 / $478.63	Facility		$269.15	$269.15	$478.63
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $213.80 / $269.15	Professional		$213.80	$213.80	$269.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $436.52 / $758.58	Facility		$213.80	$436.52	$758.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $275.42 / $398.11	Professional		$218.78	$275.42	$398.11
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $213.80 / $467.74	Facility		$213.80	$213.80	$467.74
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $426.58 / $426.58	Professional		$323.59	$426.58	$426.58
Medica Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $213.80 / $467.74	Facility		$213.80	$213.80	$467.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $213.80 / $338.84	Professional		$213.80	$213.80	$338.84
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 $213.80 / $234.42 / $691.83	Professional		$213.80	$234.42	$691.83
Quartz Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $213.80 / $1,071.52	Facility		$213.80	$213.80	$1,071.52
Quartz Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $213.80 / $213.80	Professional		$213.80	$213.80	$213.80
Security Health Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $288.40 / $354.81	Professional		$288.40	$288.40	$354.81
United Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $208.93 / $213.80	Facility		$208.93	$208.93	$213.80
United Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $213.80 / $295.12	Professional		$213.80	$213.80	$295.12