Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $54.95 / $54.95	Facility		$54.95	$54.95	$54.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $56.23 / $58.88	Professional		$54.95	$56.23	$58.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $66.07 / $89.13	Professional		$58.88	$66.07	$89.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $58.88 / $58.88	Facility		$58.88	$58.88	$58.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $58.88 / $58.88	Professional		$58.88	$58.88	$58.88
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $58.88 / $81.28	Facility		$54.95	$58.88	$81.28
Medica Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $58.88 / $100.00	Facility		$54.95	$58.88	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $69.18 / $263.03	Professional		$69.18	$69.18	$263.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $58.88 / $70.79	Professional		$50.12	$58.88	$70.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5,888.44 / $5,888.44 / $5,888.44	Professional		$5,888.44	$5,888.44	$5,888.44
Quartz Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $64.57 / $208.93	Facility		$58.88	$64.57	$208.93
Quartz Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $58.88 / $309.03	Professional		$58.88	$58.88	$309.03
United Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $69.18 / $69.18	Facility		$69.18	$69.18	$69.18
United Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $69.18 / $72.44	Professional		$69.18	$69.18	$72.44