Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $162.18 / $1,905.46	Facility		$72.44	$162.18	$1,905.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $128.82 / $263.03	Professional		$74.13	$128.82	$263.03
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 $117.49 / $181.97 / $426.58	Professional		$117.49	$181.97	$426.58
CareSource Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $89.13 / $125.89	Facility		$74.13	$89.13	$125.89
CareSource Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $123.03 / $165.96	Professional		$123.03	$123.03	$165.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $363.08 / $416.87 / $707.95	Facility		$363.08	$416.87	$707.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $309.03 / $616.60	Professional		$128.82	$309.03	$616.60
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $177.83 / $3,162.28	Facility		$83.18	$177.83	$3,162.28
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $234.42 / $363.08	Professional		$144.54	$234.42	$363.08
Medica Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $181.97 / $3,630.78	Facility		$85.11	$181.97	$3,630.78
Medica Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $288.40 / $1,230.27	Professional		$162.18	$288.40	$1,230.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $70.79	Professional		$32.36	$33.11	$70.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $263.03 / $478.63	Professional		$144.54	$263.03	$478.63
Quartz Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $1,819.70 / $2,691.53	Facility		$977.24	$1,819.70	$2,691.53
Quartz Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $371.54 / $1,230.27	Professional		$147.91	$371.54	$1,230.27
Security Health Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $562.34 / $794.33	Professional		$380.19	$562.34	$794.33
United Facility/Professional Facility Modifier Low / Median / High Price $2,344.23 / $2,818.38 / $4,677.35	Facility		$2,344.23	$2,818.38	$4,677.35
United Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $194.98 / $537.03	Professional		$97.72	$194.98	$537.03