Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $407.38 / $407.38 / $407.38	Facility		$407.38	$407.38	$407.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $407.38 / $562.34	Professional		$288.40	$407.38	$562.34
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $812.83 / $1,348.96	Facility		$812.83	$812.83	$1,348.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $758.58 / $912.01	Professional		$616.60	$758.58	$912.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $1,905.46 / $3,981.07	Facility		$398.11	$1,905.46	$3,981.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $1,174.90 / $1,548.82	Professional		$295.12	$1,174.90	$1,548.82
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $354.81 / $660.69 / $1,023.29	Facility		$354.81	$660.69	$1,023.29
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $724.44 / $977.24	Professional		$457.09	$724.44	$977.24
Medica Facility/Professional Facility Modifier Low / Median / High Price $407.38 / $812.83 / $3,388.44	Facility		$407.38	$812.83	$3,388.44
Medica Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $398.11 / $912.01	Professional		$295.12	$398.11	$912.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $70.79 / $363.08	Professional		$54.95	$70.79	$363.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $1,230.27 / $1,995.26	Professional		$812.83	$1,230.27	$1,995.26
Quartz Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $1,621.81 / $3,388.44	Facility		$398.11	$1,621.81	$3,388.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $588.84 / $4,265.80	Professional		$295.12	$588.84	$4,265.80
United Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $338.84 / $1,047.13	Facility		$295.12	$338.84	$1,047.13
United Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $398.11 / $660.69	Professional		$269.15	$398.11	$660.69