Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $125.89 / $134.90	Facility		$75.86	$125.89	$134.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $67.61 / $112.20	Professional		$57.54	$67.61	$112.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $131.83 / $218.78	Facility		$131.83	$131.83	$218.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $123.03 / $147.91	Professional		$112.20	$123.03	$147.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $302.00 / $645.65	Facility		$77.62	$302.00	$645.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $186.21 / $251.19	Professional		$56.23	$186.21	$251.19
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $107.15 / $162.18	Facility		$64.57	$107.15	$162.18
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $190.55 / $239.88	Professional		$117.49	$190.55	$239.88
Medica Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $128.82 / $645.65	Facility		$66.07	$128.82	$645.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $74.13 / $154.88	Professional		$60.26	$74.13	$154.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $63.10 / $85.11	Professional		$50.12	$63.10	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $199.53 / $380.19	Professional		$131.83	$199.53	$380.19
Quartz Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $263.03 / $776.25	Facility		$77.62	$263.03	$776.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $112.20 / $776.25	Professional		$56.23	$112.20	$776.25
United Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $69.18 / $199.53	Facility		$56.23	$69.18	$199.53
United Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $64.57 / $109.65	Professional		$47.86	$64.57	$109.65