Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $63.10 / $63.10	Facility		$63.10	$63.10	$63.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $64.57 / $107.15	Professional		$54.95	$64.57	$107.15
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $128.82 / $213.80	Facility		$128.82	$128.82	$213.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $128.82 / $194.98	Professional		$120.23	$128.82	$194.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $295.12 / $630.96	Facility		$100.00	$295.12	$630.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $186.21 / $245.47	Professional		$85.11	$186.21	$245.47
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $104.71 / $158.49	Facility		$63.10	$104.71	$158.49
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $177.83 / $223.87	Professional		$114.82	$177.83	$223.87
Medica Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $125.89 / $549.54	Facility		$64.57	$125.89	$549.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $77.62 / $144.54	Professional		$56.23	$77.62	$144.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $70.79 / $239.88	Professional		$54.95	$70.79	$239.88
Quartz Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $194.98 / $354.81	Professional		$128.82	$194.98	$354.81
Quartz Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $257.04 / $588.84	Facility		$100.00	$257.04	$588.84
Quartz Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $158.49 / $645.65	Professional		$85.11	$158.49	$645.65
United Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $85.11 / $186.21	Facility		$67.61	$85.11	$186.21
United Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $63.10 / $107.15	Professional		$46.77	$63.10	$107.15