Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $12.88 / $12.88 / $12.88	Facility		$12.88	$12.88	$12.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $12.88 / $21.88	Professional		$12.02	$12.88	$21.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $30.20 / $48.98	Facility		$30.20	$30.20	$48.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $27.54 / $33.88	Professional		$25.70	$27.54	$33.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $22.39 / $109.65 / $177.83	Facility		$22.39	$109.65	$177.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $43.65 / $50.12	Professional		$16.22	$43.65	$50.12
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $12.02 / $23.44 / $34.67	Facility		$12.02	$23.44	$34.67
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $56.23 / $63.10	Professional		$28.84	$56.23	$63.10
Medica Facility/Professional Facility Modifier Low / Median / High Price $13.80 / $28.84 / $158.49	Facility		$13.80	$28.84	$158.49
Medica Facility/Professional Professional Modifier Low / Median / High Price $12.59 / $16.60 / $34.67	Professional		$12.59	$16.60	$34.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $64.57 / $70.79	Professional		$50.12	$64.57	$70.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $48.98 / $100.00	Professional		$30.20	$48.98	$100.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $22.39 / $58.88 / $177.83	Facility		$22.39	$58.88	$177.83
Quartz Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $32.36 / $190.55	Professional		$16.22	$32.36	$190.55
United Facility/Professional Facility Modifier Low / Median / High Price $12.59 / $14.13 / $58.88	Facility		$12.59	$14.13	$58.88
United Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $14.13 / $25.12	Professional		$11.22	$14.13	$25.12