Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $173.78	Facility		$173.78	$173.78	$173.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $173.78 / $295.12	Professional		$158.49	$173.78	$295.12
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $346.74 / $575.44	Facility		$346.74	$346.74	$575.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $323.59 / $389.05	Professional		$251.19	$323.59	$389.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $794.33 / $1,698.24	Facility		$218.78	$794.33	$1,698.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $489.78 / $660.69	Professional		$162.18	$489.78	$660.69
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $281.84 / $426.58	Facility		$169.82	$281.84	$426.58
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $478.63 / $616.60	Professional		$309.03	$478.63	$616.60
Medica Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $338.84 / $1,737.80	Facility		$173.78	$338.84	$1,737.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $213.80 / $398.11	Professional		$154.88	$213.80	$398.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $70.79 / $229.09	Professional		$54.95	$70.79	$229.09
Quartz Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $524.81 / $1,000.00	Professional		$346.74	$524.81	$1,000.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $691.83 / $1,995.26	Facility		$218.78	$691.83	$1,995.26
Quartz Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $323.59 / $2,041.74	Professional		$162.18	$323.59	$2,041.74
United Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $239.88 / $524.81	Facility		$190.55	$239.88	$524.81
United Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $169.82 / $288.40	Professional		$131.83	$169.82	$288.40