Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $870.96 / $870.96	Facility		$707.95	$870.96	$870.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $524.81 / $870.96	Professional		$436.52	$524.81	$870.96
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $1,584.89 / $1,621.81	Facility		$1,258.93	$1,584.89	$1,621.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $288.40 / $2,344.23	Professional		$288.40	$288.40	$2,344.23
CareSource Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $457.09 / $457.09	Facility		$457.09	$457.09	$457.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $1,862.09 / $3,019.95	Facility		$1,621.81	$1,862.09	$3,019.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $870.96 / $1,819.70	Professional		$676.08	$870.96	$1,819.70
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $1,288.25 / $4,570.88	Facility		$371.54	$1,288.25	$4,570.88
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $3,467.37 / $3,467.37 / $3,890.45	Professional		$3,467.37	$3,467.37	$3,890.45
Medica Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $588.84 / $2,041.74	Facility		$371.54	$588.84	$2,041.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $478.63 / $2,238.72	Professional		$338.84	$478.63	$2,238.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $64.57 / $85.11	Professional		$33.11	$64.57	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,479.11 / $2,041.74	Professional		$912.01	$1,479.11	$2,041.74
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $1,174.90 / $2,754.23	Facility		$1,174.90	$1,174.90	$2,754.23
Quartz Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $2,951.21 / $2,951.21	Professional		$309.03	$2,951.21	$2,951.21
Security Health Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $602.56 / $1,258.93	Professional		$602.56	$602.56	$1,258.93
Security Health Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $1,698.24 / $3,162.28	Professional		$602.56	$1,698.24	$3,162.28
United Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $524.81 / $707.95	Facility		$436.52	$524.81	$707.95
United Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $446.68 / $1,122.02	Professional		$245.47	$446.68	$1,122.02