Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $165.96 / $165.96	Facility		$165.96	$165.96	$165.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $186.21	Professional		$162.18	$162.18	$186.21
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $316.23 / $776.25	Professional		$162.18	$316.23	$776.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $489.78 / $776.25	Facility		$162.18	$489.78	$776.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $190.55 / $213.80	Professional		$162.18	$190.55	$213.80
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $165.96 / $302.00	Facility		$162.18	$165.96	$302.00
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Professional		$190.55	$190.55	$190.55
Medica Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $169.82 / $380.19	Facility		$165.96	$169.82	$380.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $165.96 / $1,698.24	Professional		$165.96	$165.96	$1,698.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $50.12 / $70.79	Professional		$32.36	$50.12	$70.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $229.09 / $446.68	Professional		$141.25	$229.09	$446.68
Quartz Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $380.19 / $954.99	Facility		$162.18	$380.19	$954.99
Quartz Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $181.97 / $1,000.00	Professional		$162.18	$181.97	$1,000.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $218.78 / $269.15	Professional		$218.78	$218.78	$269.15
United Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $169.82 / $169.82	Facility		$169.82	$169.82	$169.82
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $169.82 / $371.54	Professional		$125.89	$169.82	$371.54