Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $138.04 / $138.04	Facility		$138.04	$138.04	$138.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $138.04 / $165.96	Professional		$97.72	$138.04	$165.96
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $363.08 / $363.08	Facility		$199.53	$363.08	$363.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $199.53 / $251.19	Professional		$151.36	$199.53	$251.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $169.82 / $776.25	Facility		$112.20	$169.82	$776.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $234.42 / $380.19	Professional		$112.20	$234.42	$380.19
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $138.04 / $199.53	Facility		$25.70	$138.04	$199.53
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $147.91 / $147.91	Professional		$147.91	$147.91	$147.91
Medica Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $165.96 / $954.99	Facility		$25.70	$165.96	$954.99
Medica Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $117.49 / $194.98	Professional		$74.13	$117.49	$194.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $10.23 / $58.88 / $144.54	Professional		$10.23	$58.88	$144.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $41.69 / $53.70	Professional		$22.39	$41.69	$53.70
Quartz Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $338.84 / $1,000.00	Facility		$112.20	$338.84	$1,000.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $112.20 / $112.20	Professional		$15.49	$112.20	$112.20
United Facility/Professional Facility Modifier Low / Median / High Price $10.23 / $77.62 / $131.83	Facility		$10.23	$77.62	$131.83
United Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $112.20 / $194.98	Professional		$70.79	$112.20	$194.98