Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $72.44 / $72.44	Facility		$72.44	$72.44	$72.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $75.86 / $128.82	Professional		$63.10	$75.86	$128.82
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $147.91 / $245.47	Facility		$147.91	$147.91	$245.47
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $138.04 / $165.96	Professional		$125.89	$138.04	$165.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $338.84 / $724.44	Facility		$128.82	$338.84	$724.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $213.80 / $281.84	Professional		$109.65	$213.80	$281.84
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $120.23 / $181.97	Facility		$72.44	$120.23	$181.97
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $204.17 / $251.19	Professional		$131.83	$204.17	$251.19
Medica Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $144.54 / $724.44	Facility		$72.44	$144.54	$724.44
Medica Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $95.50 / $165.96	Professional		$67.61	$95.50	$165.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $70.79 / $109.65	Professional		$54.95	$70.79	$109.65
Quartz Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $223.87 / $457.09	Professional		$147.91	$223.87	$457.09
Quartz Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $295.12 / $724.44	Facility		$125.89	$295.12	$724.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $181.97 / $758.58	Professional		$109.65	$181.97	$758.58
United Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $109.65 / $234.42	Facility		$85.11	$109.65	$234.42
United Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $75.86 / $123.03	Professional		$57.54	$75.86	$123.03