Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $537.03 / $724.44	Facility		$309.03	$537.03	$724.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $218.78 / $331.13	Professional		$181.97	$218.78	$331.13
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $707.95 / $724.44	Facility		$562.34	$707.95	$724.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $1,047.13	Professional		$104.71	$104.71	$1,047.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $234.42 / $234.42	Facility		$234.42	$234.42	$234.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $831.76 / $1,348.96	Facility		$724.44	$831.76	$1,348.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $389.05 / $812.83	Professional		$302.00	$389.05	$812.83
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $524.81 / $1,479.11	Facility		$128.82	$524.81	$1,479.11
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $1,548.82 / $1,737.80	Professional		$1,548.82	$1,548.82	$1,737.80
Medica Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $245.47 / $912.01	Facility		$128.82	$245.47	$912.01
Medica Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $154.88 / $933.25	Professional		$117.49	$154.88	$933.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $64.57 / $128.82	Professional		$50.12	$64.57	$128.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $616.60 / $851.14	Professional		$407.38	$616.60	$851.14
Quartz Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $524.81 / $1,230.27	Facility		$524.81	$524.81	$1,230.27
Quartz Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $1,288.25 / $1,288.25	Professional		$138.04	$1,288.25	$1,288.25
Security Health Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $549.54 / $549.54	Professional		$549.54	$549.54	$549.54
Security Health Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,412.54 / $1,819.70	Professional		$758.58	$1,412.54	$1,819.70
United Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $208.93 / $309.03	Facility		$158.49	$208.93	$309.03
United Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $154.88 / $426.58	Professional		$109.65	$154.88	$426.58