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 $114.82 / $169.82 / $288.40	Professional		$114.82	$169.82	$288.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $354.81 / $354.81 / $575.44	Facility		$354.81	$354.81	$575.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $323.59 / $389.05	Professional		$263.03	$323.59	$389.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $812.83 / $1,737.80	Facility		$162.18	$812.83	$1,737.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $501.19 / $660.69	Professional		$117.49	$501.19	$660.69
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $281.84 / $436.52	Facility		$144.54	$281.84	$436.52
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $416.87 / $512.86	Professional		$257.04	$416.87	$512.86
Medica Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $346.74 / $1,318.26	Facility		$173.78	$346.74	$1,318.26
Medica Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $194.98 / $389.05	Professional		$128.82	$194.98	$389.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $58.88 / $85.11	Professional		$43.65	$58.88	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $524.81 / $812.83	Professional		$354.81	$524.81	$812.83
Quartz Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $707.95 / $1,318.26	Facility		$162.18	$707.95	$1,318.26
Quartz Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $234.42 / $1,698.24	Professional		$117.49	$234.42	$1,698.24
United Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $194.98 / $426.58	Facility		$104.71	$194.98	$426.58
United Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $173.78 / $288.40	Professional		$114.82	$173.78	$288.40