Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $870.96 / $870.96	Facility		$870.96	$870.96	$870.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $831.76 / $1,000.00	Professional		$501.19	$831.76	$1,000.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,000.00 / $1,621.81	Facility		$1,000.00	$1,000.00	$1,621.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $933.25 / $1,047.13	Professional		$724.44	$933.25	$1,047.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $812.83 / $1,258.93	Facility		$125.89	$812.83	$1,258.93
CareSource Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $812.83 / $1,230.27	Professional		$125.89	$812.83	$1,230.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $2,951.21 / $4,897.79	Facility		$891.25	$2,951.21	$4,897.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $4,365.16 / $5,128.61	Professional		$758.58	$4,365.16	$5,128.61
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $758.58 / $1,230.27	Facility		$93.33	$758.58	$1,230.27
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $616.60 / $831.76	Professional		$158.49	$616.60	$831.76
Medica Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $870.96 / $4,786.30	Facility		$97.72	$870.96	$4,786.30
Medica Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $107.15 / $4,677.35	Professional		$51.29	$107.15	$4,677.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $64.57 / $89.13	Professional		$54.95	$64.57	$89.13
Quartz Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $190.55 / $302.00	Professional		$100.00	$190.55	$302.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $4,786.30 / $4,786.30 / $5,011.87	Facility		$4,786.30	$4,786.30	$5,011.87
Quartz Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $3,801.89 / $4,677.35	Professional		$758.58	$3,801.89	$4,677.35
United Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $199.53 / $2,187.76	Facility		$67.61	$199.53	$2,187.76
United Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $107.15 / $870.96	Professional		$51.29	$107.15	$870.96