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 $75.86 / $100.00 / $169.82	Professional		$75.86	$100.00	$169.82
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $309.03	Facility		$190.55	$190.55	$309.03
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 $120.23 / $436.52 / $933.25	Facility		$120.23	$436.52	$933.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $269.15 / $354.81	Professional		$87.10	$269.15	$354.81
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $151.36 / $234.42	Facility		$93.33	$151.36	$234.42
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $251.19 / $316.23	Professional		$169.82	$251.19	$316.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $186.21 / $870.96	Facility		$95.50	$186.21	$870.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $100.00 / $208.93	Professional		$81.28	$100.00	$208.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $70.79 / $100.00	Professional		$54.95	$70.79	$100.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $281.84 / $537.03	Professional		$190.55	$281.84	$537.03
Quartz Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $380.19 / $870.96	Facility		$120.23	$380.19	$870.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $173.78 / $1,000.00	Professional		$87.10	$173.78	$1,000.00
United Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $89.13 / $275.42	Facility		$72.44	$89.13	$275.42
United Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $93.33 / $158.49	Professional		$66.07	$93.33	$158.49