Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $97.72 / $97.72	Facility		$97.72	$97.72	$97.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $102.33 / $169.82	Professional		$83.18	$102.33	$169.82
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $199.53 / $331.13	Facility		$199.53	$199.53	$331.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $186.21 / $223.87	Professional		$147.91	$186.21	$223.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $457.09 / $977.24	Facility		$112.20	$457.09	$977.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $281.84 / $380.19	Professional		$81.28	$281.84	$380.19
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $162.18 / $245.47	Facility		$97.72	$162.18	$245.47
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $295.12 / $371.54	Professional		$177.83	$295.12	$371.54
Medica Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $194.98 / $912.01	Facility		$97.72	$194.98	$912.01
Medica Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $102.33 / $218.78	Professional		$87.10	$102.33	$218.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $70.79 / $131.83	Professional		$54.95	$70.79	$131.83
Quartz Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $302.00 / $549.54	Professional		$199.53	$302.00	$549.54
Quartz Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $398.11 / $912.01	Facility		$112.20	$398.11	$912.01
Quartz Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $213.80 / $977.24	Professional		$81.28	$213.80	$977.24
United Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $97.72 / $281.84	Facility		$81.28	$97.72	$281.84
United Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $97.72 / $165.96	Professional		$67.61	$97.72	$165.96