Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $19.05 / $19.05 / $19.05	Facility		$19.05	$19.05	$19.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $20.89 / $28.84	Professional		$15.14	$20.89	$28.84
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $34.67 / $56.23	Facility		$34.67	$34.67	$56.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $31.62 / $36.31	Professional		$31.62	$31.62	$36.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $104.71 / $169.82	Facility		$89.13	$104.71	$169.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $48.98 / $64.57	Professional		$13.80	$48.98	$64.57
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $19.05 / $25.70 / $48.98	Facility		$19.05	$25.70	$48.98
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $33.88 / $40.74	Professional		$21.38	$33.88	$40.74
Medica Facility/Professional Facility Modifier Low / Median / High Price $19.05 / $27.54 / $67.61	Facility		$19.05	$27.54	$67.61
Medica Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $16.98 / $257.04	Professional		$14.13	$16.98	$257.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $33.11 / $70.79	Professional		$19.50	$33.11	$70.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $51.29 / $93.33	Professional		$34.67	$51.29	$93.33
Quartz Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $67.61 / $158.49	Facility		$67.61	$67.61	$158.49
Quartz Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $51.29 / $269.15	Professional		$13.80	$51.29	$269.15
United Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $16.98 / $26.92	Professional		$11.22	$16.98	$26.92