Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $64.57 / $64.57	Facility		$64.57	$64.57	$64.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $67.61 / $114.82	Professional		$56.23	$67.61	$114.82
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $107.15 / $177.83	Facility		$107.15	$107.15	$177.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $107.15 / $120.23	Professional		$100.00	$107.15	$120.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $436.52 / $602.56	Facility		$128.82	$436.52	$602.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $173.78 / $199.53	Professional		$93.33	$173.78	$199.53
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $104.71 / $162.18	Facility		$64.57	$104.71	$162.18
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $158.49 / $177.83	Professional		$104.71	$158.49	$177.83
Medica Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $117.49 / $537.03	Facility		$64.57	$117.49	$537.03
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 $50.12 / $64.57 / $79.43	Professional		$50.12	$64.57	$79.43
Quartz Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $125.89 / $245.47	Professional		$87.10	$125.89	$245.47
Quartz Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $208.93 / $537.03	Facility		$128.82	$208.93	$537.03
Quartz Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $173.78 / $812.83	Professional		$93.33	$173.78	$812.83
United Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $95.50 / $234.42	Facility		$81.28	$95.50	$234.42
United Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $97.72 / $158.49	Professional		$64.57	$97.72	$158.49