Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $489.78 / $489.78	Facility		$489.78	$489.78	$489.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $602.56 / $1,659.59	Professional		$446.68	$602.56	$1,659.59
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $776.25 / $1,288.25	Facility		$776.25	$776.25	$1,288.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $741.31 / $870.96	Professional		$724.44	$741.31	$870.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $3,548.13 / $4,365.16	Facility		$812.83	$3,548.13	$4,365.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $1,288.25 / $1,479.11	Professional		$588.84	$1,288.25	$1,479.11
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $758.58 / $1,288.25	Facility		$489.78	$758.58	$1,288.25
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,230.27 / $1,412.54	Professional		$758.58	$1,230.27	$1,412.54
Medica Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $870.96 / $3,890.45	Facility		$489.78	$870.96	$3,890.45
Medica Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $794.33 / $1,584.89	Professional		$630.96	$794.33	$1,584.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $70.79 / $416.87	Professional		$54.95	$70.79	$416.87
Quartz Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $933.25 / $1,905.46	Professional		$630.96	$933.25	$1,905.46
Quartz Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $1,548.82 / $3,890.45	Facility		$812.83	$1,548.82	$3,890.45
Quartz Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $1,174.90 / $6,456.54	Professional		$588.84	$1,174.90	$6,456.54
United Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $691.83 / $1,737.80	Facility		$588.84	$691.83	$1,737.80
United Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $776.25 / $1,230.27	Professional		$524.81	$776.25	$1,230.27