Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $407.38 / $407.38 / $407.38	Facility		$407.38	$407.38	$407.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $446.68 / $831.76	Professional		$363.08	$446.68	$831.76
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $676.08 / $1,122.02	Facility		$676.08	$676.08	$1,122.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $676.08 / $758.58	Professional		$630.96	$676.08	$758.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $2,754.23 / $3,801.89	Facility		$758.58	$2,754.23	$3,801.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $1,122.02 / $1,258.93	Professional		$549.54	$1,122.02	$1,258.93
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $407.38 / $660.69 / $1,023.29	Facility		$407.38	$660.69	$1,023.29
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $1,023.29 / $1,122.02	Professional		$660.69	$1,023.29	$1,122.02
Medica Facility/Professional Facility Modifier Low / Median / High Price $407.38 / $741.31 / $3,388.44	Facility		$407.38	$741.31	$3,388.44
Medica Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $660.69 / $1,380.38	Professional		$549.54	$660.69	$1,380.38
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 $549.54 / $794.33 / $1,548.82	Professional		$549.54	$794.33	$1,548.82
Quartz Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $1,348.96 / $3,388.44	Facility		$758.58	$1,348.96	$3,388.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $1,096.48 / $5,128.61	Professional		$549.54	$1,096.48	$5,128.61
United Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $602.56 / $1,479.11	Facility		$524.81	$602.56	$1,479.11
United Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $616.60 / $1,000.00	Professional		$407.38	$616.60	$1,000.00