Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $58.88 / $58.88	Facility		$58.88	$58.88	$58.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $66.07 / $100.00	Professional		$57.54	$66.07	$100.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $120.23 / $194.98	Facility		$120.23	$120.23	$194.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $112.20 / $134.90	Professional		$107.15	$112.20	$134.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $275.42 / $588.84	Facility		$75.86	$275.42	$588.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $169.82 / $223.87	Professional		$54.95	$169.82	$223.87
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $95.50 / $147.91	Facility		$58.88	$95.50	$147.91
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $234.42 / $295.12	Professional		$107.15	$234.42	$295.12
Medica Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $117.49 / $602.56	Facility		$60.26	$117.49	$602.56
Medica Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $67.61 / $141.25	Professional		$54.95	$67.61	$141.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $58.88 / $85.11	Professional		$44.67	$58.88	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $181.97 / $363.08	Professional		$120.23	$181.97	$363.08
Quartz Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $239.88 / $741.31	Facility		$75.86	$239.88	$741.31
Quartz Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $109.65 / $812.83	Professional		$54.95	$109.65	$812.83
United Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $67.61 / $190.55	Facility		$53.70	$67.61	$190.55
United Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $58.88 / $100.00	Professional		$45.71	$58.88	$100.00