Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Facility		$75.86	$75.86	$75.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $75.86 / $112.20	Professional		$56.23	$75.86	$112.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $154.88 / $251.19	Facility		$154.88	$154.88	$251.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $141.25 / $169.82	Professional		$128.82	$141.25	$169.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $354.81 / $758.58	Facility		$97.72	$354.81	$758.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $218.78 / $288.40	Professional		$70.79	$218.78	$288.40
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $123.03 / $190.55	Facility		$66.07	$123.03	$190.55
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $151.36 / $181.97	Professional		$87.10	$151.36	$181.97
Medica Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $151.36 / $630.96	Facility		$75.86	$151.36	$630.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $89.13 / $169.82	Professional		$58.88	$89.13	$169.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $64.57 / $85.11	Professional		$50.12	$64.57	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $229.09 / $371.54	Professional		$154.88	$229.09	$371.54
Quartz Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $309.03 / $741.31	Facility		$97.72	$309.03	$741.31
Quartz Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $131.83 / $758.58	Professional		$70.79	$131.83	$758.58
United Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $89.13 / $190.55	Facility		$69.18	$89.13	$190.55
United Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $75.86 / $125.89	Professional		$50.12	$75.86	$125.89