Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $1,995.26 / $3,388.44	Facility		$645.65	$1,995.26	$3,388.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $251.19 / $977.24	Professional		$93.33	$251.19	$977.24
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 $144.54 / $245.47 / $549.54	Professional		$144.54	$245.47	$549.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $112.20 / $158.49	Facility		$93.33	$112.20	$158.49
CareSource Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $239.88 / $316.23	Professional		$239.88	$239.88	$316.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $812.83 / $1,318.26	Facility		$707.95	$812.83	$1,318.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $426.58 / $1,174.90	Professional		$165.96	$426.58	$1,174.90
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $288.40 / $3,162.28	Facility		$102.33	$288.40	$3,162.28
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $331.13 / $707.95	Professional		$181.97	$331.13	$707.95
Medica Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $478.63 / $3,630.78	Facility		$117.49	$478.63	$3,630.78
Medica Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $457.09 / $1,905.46	Professional		$251.19	$457.09	$1,905.46
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 $173.78 / $426.58 / $912.01	Professional		$173.78	$426.58	$912.01
Quartz Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $1,445.44 / $2,951.21	Facility		$758.58	$1,445.44	$2,951.21
Quartz Facility/Professional Facility Modifier 53 Low / Median / High Price $288.40 / $288.40 / $426.58	Facility	53	$288.40	$288.40	$426.58
Quartz Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $630.96 / $1,819.70	Professional		$190.55	$630.96	$1,819.70
Security Health Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $870.96 / $1,513.56	Professional		$426.58	$870.96	$1,513.56
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 $114.82 / $302.00 / $870.96	Professional		$114.82	$302.00	$870.96