Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $109.65 / $416.87	Facility		$75.86	$109.65	$416.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $74.13 / $97.72	Professional		$72.44	$74.13	$97.72
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $93.33 / $165.96	Facility		$93.33	$93.33	$165.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $74.13 / $93.33	Professional		$74.13	$74.13	$93.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $107.15 / $194.98	Facility		$74.13	$107.15	$194.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $77.62 / $151.36	Professional		$74.13	$77.62	$151.36
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $74.13 / $81.28	Facility		$74.13	$74.13	$81.28
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $147.91 / $151.36	Professional		$77.62	$147.91	$151.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $74.13 / $81.28	Facility		$70.79	$74.13	$81.28
Medica Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $81.28 / $309.03	Professional		$74.13	$81.28	$309.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $58.88 / $74.13	Professional		$32.36	$58.88	$74.13
Quartz Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $114.82 / $218.78	Professional		$74.13	$114.82	$218.78
Quartz Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $74.13 / $371.54	Facility		$74.13	$74.13	$371.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $117.49 / $316.23	Professional		$74.13	$117.49	$316.23
Security Health Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $79.43 / $123.03	Professional		$56.23	$79.43	$123.03
United Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $70.79 / $74.13	Facility		$70.79	$70.79	$74.13
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $77.62 / $83.18	Professional		$74.13	$77.62	$83.18