Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $77.62 / $77.62	Facility		$77.62	$77.62	$77.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $77.62 / $131.83	Professional		$67.61	$77.62	$131.83
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $158.49 / $263.03	Facility		$158.49	$158.49	$263.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $147.91 / $177.83	Professional		$134.90	$147.91	$177.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $363.08 / $776.25	Facility		$100.00	$363.08	$776.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $223.87 / $302.00	Professional		$72.44	$223.87	$302.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $128.82 / $194.98	Facility		$75.86	$128.82	$194.98
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $213.80 / $269.15	Professional		$141.25	$213.80	$269.15
Medica Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $154.88 / $724.44	Facility		$77.62	$154.88	$724.44
Medica Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $97.72 / $173.78	Professional		$69.18	$97.72	$173.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $70.79 / $85.11	Professional		$51.29	$70.79	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $234.42 / $436.52	Professional		$158.49	$234.42	$436.52
Quartz Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $316.23 / $724.44	Facility		$100.00	$316.23	$724.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $144.54 / $776.25	Professional		$72.44	$144.54	$776.25
United Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $104.71 / $223.87	Facility		$81.28	$104.71	$223.87
United Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $77.62 / $128.82	Professional		$57.54	$77.62	$128.82