Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $1,513.56 / $1,862.09	Facility		$812.83	$1,513.56	$1,862.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $537.03 / $812.83	Professional		$204.17	$537.03	$812.83
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,445.44 / $1,819.70 / $1,862.09	Facility		$1,445.44	$1,819.70	$1,862.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $1,995.26	Professional		$112.20	$112.20	$1,995.26
CareSource Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $1,023.29 / $1,737.80	Facility		$676.08	$1,023.29	$1,737.80
CareSource Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $741.31 / $954.99	Professional		$676.08	$741.31	$954.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $2,187.76 / $3,467.37	Facility		$1,862.09	$2,187.76	$3,467.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,174.90 / $2,089.30	Professional		$776.25	$1,174.90	$2,089.30
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $1,318.26 / $2,041.74	Facility		$741.31	$1,318.26	$2,041.74
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $4,073.80 / $4,073.80 / $4,466.84	Professional		$4,073.80	$4,073.80	$4,466.84
Medica Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $812.83 / $2,344.23	Facility		$602.56	$812.83	$2,344.23
Medica Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $169.82 / $3,388.44	Professional		$125.89	$169.82	$3,388.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $70.79 / $676.08	Professional		$33.11	$70.79	$676.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,584.89 / $2,238.72	Professional		$1,096.48	$1,584.89	$2,238.72
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $3,235.94 / $3,235.94	Facility		$1,584.89	$3,235.94	$3,235.94
Quartz Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $2,691.53 / $3,388.44	Professional		$676.08	$2,691.53	$3,388.44
Security Health Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $281.84 / $1,445.44	Professional		$281.84	$281.84	$1,445.44
Security Health Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $812.83 / $3,715.35	Professional		$281.84	$812.83	$3,715.35
United Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $223.87 / $812.83	Facility		$223.87	$223.87	$812.83
United Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $169.82 / $676.08	Professional		$123.03	$169.82	$676.08