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 $245.47 / $275.42 / $389.05	Professional		$245.47	$275.42	$389.05
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 $158.49 / $158.49 / $1,288.25	Professional		$158.49	$158.49	$1,288.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $257.04 / $257.04	Facility		$257.04	$257.04	$257.04
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 / $467.74 / $1,000.00	Professional		$371.54	$467.74	$1,000.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $707.95 / $2,570.40	Facility		$169.82	$707.95	$2,570.40
Medica Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $288.40 / $1,548.82	Facility		$169.82	$288.40	$1,548.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $269.15 / $724.44	Professional		$186.21	$269.15	$724.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $85.11 / $323.59	Professional		$54.95	$85.11	$323.59
Quartz Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $831.76 / $1,122.02	Professional		$416.87	$831.76	$1,122.02
Quartz Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $645.65 / $1,548.82	Facility		$645.65	$645.65	$1,548.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $169.82 / $213.80	Professional		$169.82	$169.82	$213.80
Security Health Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $331.13 / $691.83	Professional		$331.13	$331.13	$691.83
Security Health Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $331.13 / $1,778.28	Professional		$331.13	$331.13	$1,778.28
United Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $288.40 / $389.05	Facility		$245.47	$288.40	$389.05
United Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $263.03 / $724.44	Professional		$162.18	$263.03	$724.44