Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $724.44 / $891.25	Facility		$389.05	$724.44	$891.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $281.84 / $478.63	Professional		$229.09	$281.84	$478.63
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $870.96 / $891.25	Facility		$691.83	$870.96	$891.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $128.82 / $1,288.25	Professional		$128.82	$128.82	$1,288.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $323.59 / $436.52	Facility		$323.59	$323.59	$436.52
CareSource Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $323.59 / $457.09	Professional		$323.59	$323.59	$457.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $1,047.13 / $1,659.59	Facility		$891.25	$1,047.13	$1,659.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $776.25 / $1,023.29	Professional		$371.54	$776.25	$1,023.29
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $354.81 / $1,348.96 / $1,949.84	Facility		$354.81	$1,348.96	$1,949.84
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,949.84 / $1,949.84 / $2,137.96	Professional		$1,949.84	$1,949.84	$2,137.96
Medica Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $389.05 / $1,148.15	Facility		$295.12	$389.05	$1,148.15
Medica Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $199.53 / $1,621.81	Professional		$144.54	$199.53	$1,621.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $70.79 / $302.00	Professional		$54.95	$70.79	$302.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $758.58 / $1,071.52	Professional		$562.34	$758.58	$1,071.52
Quartz Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $1,548.82 / $1,548.82	Facility		$645.65	$1,548.82	$1,548.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $1,621.81 / $1,621.81	Professional		$389.05	$1,621.81	$1,621.81
Security Health Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $251.19 / $691.83	Professional		$251.19	$251.19	$691.83
Security Health Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $954.99 / $1,778.28	Professional		$251.19	$954.99	$1,778.28
United Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $257.04 / $389.05	Facility		$257.04	$257.04	$389.05
United Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $199.53 / $537.03	Professional		$134.90	$199.53	$537.03