Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $478.63 / $478.63	Facility		$478.63	$478.63	$478.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $478.63 / $776.25	Professional		$380.19	$478.63	$776.25
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $977.24 / $1,584.89	Facility		$977.24	$977.24	$1,584.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $891.25 / $1,071.52	Professional		$630.96	$891.25	$1,071.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $2,238.72 / $4,786.30	Facility		$524.81	$2,238.72	$4,786.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $1,380.38 / $1,819.70	Professional		$389.05	$1,380.38	$1,819.70
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $776.25 / $1,202.26	Facility		$446.68	$776.25	$1,202.26
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,288.25 / $1,621.81	Professional		$870.96	$1,288.25	$1,621.81
Medica Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $954.99 / $4,168.69	Facility		$478.63	$954.99	$4,168.69
Medica Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $575.44 / $1,071.52	Professional		$398.11	$575.44	$1,071.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $70.79 / $602.56	Professional		$54.95	$70.79	$602.56
Quartz Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,445.44 / $2,511.89	Professional		$977.24	$1,445.44	$2,511.89
Quartz Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $1,905.46 / $4,466.84	Facility		$524.81	$1,905.46	$4,466.84
Quartz Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $1,000.00 / $4,570.88	Professional		$389.05	$1,000.00	$4,570.88
United Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $602.56 / $1,318.26	Facility		$478.63	$602.56	$1,318.26
United Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $478.63 / $794.33	Professional		$331.13	$478.63	$794.33