Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $93.33 / $93.33	Facility		$93.33	$93.33	$93.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $91.20 / $125.89	Professional		$64.57	$91.20	$125.89
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $316.23	Facility		$190.55	$190.55	$316.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $177.83 / $213.80	Professional		$162.18	$177.83	$213.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $436.52 / $933.25	Facility		$89.13	$436.52	$933.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $269.15 / $363.08	Professional		$64.57	$269.15	$363.08
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $154.88 / $234.42	Facility		$77.62	$154.88	$234.42
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $177.83 / $213.80	Professional		$162.18	$177.83	$213.80
Medica Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $186.21 / $758.58	Facility		$91.20	$186.21	$758.58
Medica Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $93.33 / $213.80	Professional		$64.57	$93.33	$213.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $70.79 / $123.03	Professional		$54.95	$70.79	$123.03
Quartz Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $288.40 / $446.68	Professional		$190.55	$288.40	$446.68
Quartz Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $380.19 / $831.76	Facility		$89.13	$380.19	$831.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $128.82 / $891.25	Professional		$64.57	$128.82	$891.25
United Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $79.43 / $229.09	Facility		$64.57	$79.43	$229.09
United Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $93.33 / $154.88	Professional		$61.66	$93.33	$154.88