Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $1,698.24 / $2,089.30	Facility		$912.01	$1,698.24	$2,089.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $645.65 / $954.99	Professional		$549.54	$645.65	$954.99
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $2,041.74 / $2,089.30	Facility		$1,621.81	$2,041.74	$2,089.30
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $302.00 / $3,019.95	Professional		$302.00	$302.00	$3,019.95
CareSource Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $1,023.29 / $1,949.84	Facility		$758.58	$1,023.29	$1,949.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $794.33 / $1,071.52	Professional		$758.58	$794.33	$1,071.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,089.30 / $2,454.71 / $3,890.45	Facility		$2,089.30	$2,454.71	$3,890.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,148.15 / $2,344.23	Professional		$870.96	$1,148.15	$2,344.23
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $1,513.56 / $4,570.88	Facility		$457.09	$1,513.56	$4,570.88
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $4,570.88 / $4,570.88 / $5,011.87	Professional		$4,570.88	$4,570.88	$5,011.87
Medica Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $724.44 / $2,630.27	Facility		$457.09	$724.44	$2,630.27
Medica Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $478.63 / $2,754.23	Professional		$338.84	$478.63	$2,754.23
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 $1,174.90 / $1,778.28 / $2,511.89	Professional		$1,174.90	$1,778.28	$2,511.89
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $1,513.56 / $3,630.78	Facility		$1,513.56	$1,513.56	$3,630.78
Quartz Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $3,801.89 / $3,801.89	Professional		$363.08	$3,801.89	$3,801.89
Security Health Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $602.56 / $1,621.81	Professional		$602.56	$602.56	$1,621.81
Security Health Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $2,754.23 / $4,168.69	Professional		$602.56	$2,754.23	$4,168.69
United Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $602.56 / $912.01	Facility		$436.52	$602.56	$912.01
United Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $478.63 / $1,318.26	Professional		$316.23	$478.63	$1,318.26