Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $977.24 / $2,951.21	Facility		$194.98	$977.24	$2,951.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $208.93 / $691.83	Professional		$134.90	$208.93	$691.83
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $3,090.30 / $5,754.40	Facility		$1,584.89	$3,090.30	$5,754.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $309.03 / $891.25	Professional		$165.96	$309.03	$891.25
CareSource Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $323.59 / $363.08	Professional		$323.59	$323.59	$363.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $501.19 / $794.33	Facility		$426.58	$501.19	$794.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $416.87 / $588.84	Professional		$251.19	$416.87	$588.84
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $331.13 / $3,801.89	Facility		$147.91	$331.13	$3,801.89
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $389.05 / $478.63	Professional		$288.40	$389.05	$478.63
Medica Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $1,584.89 / $4,466.84	Facility		$147.91	$1,584.89	$4,466.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $354.81 / $1,000.00	Professional		$194.98	$354.81	$1,000.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $50.12 / $407.38	Professional		$32.36	$50.12	$407.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $389.05 / $588.84	Professional		$257.04	$389.05	$588.84
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $1,905.46 / $1,905.46	Facility		$1,288.25	$1,905.46	$1,905.46
Quartz Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $794.33 / $1,174.90	Professional		$251.19	$794.33	$1,174.90
Security Health Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $933.25 / $1,122.02	Professional		$691.83	$933.25	$1,122.02
United Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $2,818.38 / $4,677.35	Facility		$2,238.72	$2,818.38	$4,677.35
United Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $316.23 / $707.95	Professional		$162.18	$316.23	$707.95