Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $128.82 / $128.82	Facility		$128.82	$128.82	$128.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $128.82 / $173.78	Professional		$85.11	$128.82	$173.78
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $257.04 / $426.58	Facility		$257.04	$257.04	$426.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $239.88 / $288.40	Professional		$218.78	$239.88	$288.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $602.56 / $1,288.25	Facility		$120.23	$602.56	$1,288.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $371.54 / $489.78	Professional		$87.10	$371.54	$489.78
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $208.93 / $323.59	Facility		$107.15	$208.93	$323.59
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $229.09 / $309.03	Professional		$144.54	$229.09	$309.03
Medica Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $257.04 / $977.24	Facility		$128.82	$257.04	$977.24
Medica Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $125.89 / $288.40	Professional		$95.50	$125.89	$288.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $70.79 / $138.04	Professional		$54.95	$70.79	$138.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $389.05 / $602.56	Professional		$257.04	$389.05	$602.56
Quartz Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $512.86 / $977.24	Facility		$120.23	$512.86	$977.24
Quartz Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $173.78 / $1,148.15	Professional		$87.10	$173.78	$1,148.15
United Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $104.71 / $309.03	Facility		$87.10	$104.71	$309.03
United Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $125.89 / $208.93	Professional		$85.11	$125.89	$208.93