Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $57.54 / $57.54	Facility		$57.54	$57.54	$57.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $57.54 / $77.62	Professional		$39.81	$57.54	$77.62
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $117.49 / $194.98	Facility		$117.49	$117.49	$194.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $109.65 / $128.82	Professional		$89.13	$109.65	$128.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $269.15 / $575.44	Facility		$53.70	$269.15	$575.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $165.96 / $223.87	Professional		$39.81	$165.96	$223.87
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $95.50 / $144.54	Facility		$47.86	$95.50	$144.54
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $120.23 / $141.25	Professional		$104.71	$120.23	$141.25
Medica Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $114.82 / $457.09	Facility		$56.23	$114.82	$457.09
Medica Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $57.54 / $128.82	Professional		$40.74	$57.54	$128.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $67.61 / $85.11	Professional		$50.12	$67.61	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $177.83 / $269.15	Professional		$117.49	$177.83	$269.15
Quartz Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $234.42 / $549.54	Facility		$53.70	$234.42	$549.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $79.43 / $912.01	Professional		$39.81	$79.43	$912.01
United Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $50.12 / $141.25	Facility		$39.81	$50.12	$141.25
United Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $57.54 / $95.50	Professional		$38.02	$57.54	$95.50