Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $851.14 / $4,570.88 / $10,715.19	Facility		$851.14	$4,570.88	$10,715.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $1,096.48 / $4,570.88	Professional		$380.19	$1,096.48	$4,570.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $12,022.64 / $16,982.44 / $28,840.32	Facility		$12,022.64	$16,982.44	$28,840.32
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $1,071.52 / $2,344.23	Professional		$602.56	$1,071.52	$2,344.23
CareSource Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $467.74 / $467.74	Facility		$467.74	$467.74	$467.74
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,630.27 / $2,630.27 / $2,630.27	Professional		$2,630.27	$2,630.27	$2,630.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $6,309.57 / $7,244.36 / $11,748.98	Facility		$6,309.57	$7,244.36	$11,748.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $1,862.09 / $10,471.29	Professional		$676.08	$1,862.09	$10,471.29
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $2,238.72 / $4,365.16	Facility		$416.87	$2,238.72	$4,365.16
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,445.44 / $5,888.44	Professional		$758.58	$1,445.44	$5,888.44
Medica Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $2,398.83 / $14,125.38	Facility		$426.58	$2,398.83	$14,125.38
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,584.89 / $3,388.44 / $16,982.44	Professional		$1,584.89	$3,388.44	$16,982.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $85.11	Professional		$32.36	$33.11	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $2,630.27 / $7,762.47	Professional		$724.44	$2,630.27	$7,762.47
Quartz Facility/Professional Facility Modifier Low / Median / High Price $19,498.45 / $28,840.32 / $28,840.32	Facility		$19,498.45	$28,840.32	$28,840.32
Quartz Facility/Professional Facility Modifier 53 Low / Median / High Price $3,890.45 / $3,890.45 / $5,754.40	Facility	53	$3,890.45	$3,890.45	$5,754.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $9,332.54 / $15,848.93	Professional		$794.33	$9,332.54	$15,848.93
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $2,691.53 / $13,489.63	Professional		$1,479.11	$2,691.53	$13,489.63
United Facility/Professional Facility Modifier Low / Median / High Price $6,165.95 / $13,803.84 / $17,378.01	Facility		$6,165.95	$13,803.84	$17,378.01
United Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $1,659.59 / $5,623.41	Professional		$467.74	$1,659.59	$5,623.41