Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $64.57 / $64.57	Facility		$64.57	$64.57	$64.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $64.57 / $97.72	Professional		$52.48	$64.57	$97.72
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $131.83 / $218.78	Facility		$131.83	$131.83	$218.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $123.03 / $147.91	Professional		$120.23	$123.03	$147.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $309.03 / $660.69	Facility		$75.86	$309.03	$660.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $190.55 / $251.19	Professional		$54.95	$190.55	$251.19
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $107.15 / $165.96	Facility		$60.26	$107.15	$165.96
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $158.49 / $194.98	Professional		$117.49	$158.49	$194.98
Medica Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $131.83 / $562.34	Facility		$66.07	$131.83	$562.34
Medica Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $64.57 / $147.91	Professional		$51.29	$64.57	$147.91
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 $131.83 / $199.53 / $338.84	Professional		$131.83	$199.53	$338.84
Quartz Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $263.03 / $676.08	Facility		$75.86	$263.03	$676.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $109.65 / $707.95	Professional		$54.95	$109.65	$707.95
United Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $63.10 / $177.83	Facility		$50.12	$63.10	$177.83
United Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $64.57 / $109.65	Professional		$43.65	$64.57	$109.65