Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $114.82	Facility		$114.82	$114.82	$114.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $117.49 / $190.55	Professional		$100.00	$117.49	$190.55
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $229.09 / $380.19	Facility		$229.09	$229.09	$380.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $213.80 / $257.04	Professional		$208.93	$213.80	$257.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $537.03 / $1,148.15	Facility		$134.90	$537.03	$1,148.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $331.13 / $436.52	Professional		$100.00	$331.13	$436.52
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $186.21 / $288.40	Facility		$114.82	$186.21	$288.40
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $229.09 / $288.40	Professional		$128.82	$229.09	$288.40
Medica Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $229.09 / $1,148.15	Facility		$117.49	$229.09	$1,148.15
Medica Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $131.83 / $269.15	Professional		$102.33	$131.83	$269.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $70.79 / $208.93	Professional		$54.95	$70.79	$208.93
Quartz Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $346.74 / $676.08	Professional		$229.09	$346.74	$676.08
Quartz Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $457.09 / $1,380.38	Facility		$134.90	$457.09	$1,380.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $199.53 / $2,884.03	Professional		$100.00	$199.53	$2,884.03
United Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $125.89 / $354.81	Facility		$85.11	$125.89	$354.81
United Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $112.20 / $194.98	Professional		$85.11	$112.20	$194.98