Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $117.49 / $117.49	Facility		$117.49	$117.49	$117.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $114.82 / $186.21	Professional		$79.43	$114.82	$186.21
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $239.88 / $398.11	Facility		$239.88	$239.88	$398.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $223.87 / $269.15	Professional		$177.83	$223.87	$269.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $549.54 / $1,174.90	Facility		$112.20	$549.54	$1,174.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $338.84 / $457.09	Professional		$83.18	$338.84	$457.09
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $194.98 / $295.12	Facility		$97.72	$194.98	$295.12
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $263.03 / $316.23	Professional		$208.93	$263.03	$316.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $234.42 / $912.01	Facility		$117.49	$234.42	$912.01
Medica Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $131.83 / $263.03	Professional		$87.10	$131.83	$263.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $70.79 / $158.49	Professional		$54.95	$70.79	$158.49
Quartz Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $354.81 / $549.54	Professional		$239.88	$354.81	$549.54
Quartz Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $478.63 / $1,000.00	Facility		$112.20	$478.63	$1,000.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $165.96 / $1,096.48	Professional		$83.18	$165.96	$1,096.48
United Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $131.83 / $288.40	Facility		$75.86	$131.83	$288.40
United Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $117.49 / $194.98	Professional		$77.62	$117.49	$194.98