Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $1,479.11 / $1,479.11	Facility		$645.65	$1,479.11	$1,479.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $446.68 / $645.65	Professional		$380.19	$446.68	$645.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $50.12 / $1,584.89	Professional		$50.12	$50.12	$1,584.89
CareSource Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $371.54 / $371.54	Facility		$371.54	$371.54	$371.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,479.11 / $1,737.80 / $2,754.23	Facility		$1,479.11	$1,737.80	$2,754.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $776.25 / $1,698.24	Professional		$616.60	$776.25	$1,698.24
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $1,862.09 / $3,162.28	Facility		$380.19	$1,862.09	$3,162.28
Medica Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $512.86 / $2,570.40	Facility		$269.15	$512.86	$2,570.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $323.59 / $977.24	Professional		$269.15	$323.59	$977.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $85.11 / $537.03	Professional		$54.95	$85.11	$537.03
Quartz Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $1,258.93 / $1,778.28	Professional		$691.83	$1,258.93	$1,778.28
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,071.52 / $1,071.52 / $2,570.40	Facility		$1,071.52	$1,071.52	$2,570.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $288.40 / $288.40	Professional		$288.40	$288.40	$288.40
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,148.15 / $1,148.15	Professional		$1,148.15	$1,148.15	$1,148.15
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,584.89 / $2,951.21 / $4,073.80	Professional		$1,584.89	$2,951.21	$4,073.80
United Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $436.52 / $645.65	Facility		$436.52	$436.52	$645.65
United Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $323.59 / $1,047.13	Professional		$229.09	$323.59	$1,047.13