Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $1,513.56 / $6,025.60	Facility		$794.33	$1,513.56	$6,025.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,230.27 / $3,162.28	Professional		$758.58	$1,230.27	$3,162.28
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $954.99 / $1,698.24	Facility		$954.99	$954.99	$1,698.24
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $758.58 / $977.24	Professional		$758.58	$758.58	$977.24
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,071.52 / $1,071.52 / $1,148.15	Facility		$1,071.52	$1,071.52	$1,148.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $1,698.24 / $2,951.21	Facility		$758.58	$1,698.24	$2,951.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $977.24 / $1,412.54	Professional		$776.25	$977.24	$1,412.54
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $776.25 / $1,698.24	Facility		$776.25	$776.25	$1,698.24
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,548.82 / $1,548.82	Professional		$1,148.15	$1,548.82	$1,548.82
Medica Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $794.33 / $2,089.30	Facility		$794.33	$794.33	$2,089.30
Medica Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $794.33 / $1,258.93	Professional		$794.33	$794.33	$1,258.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $64.57 / $85.11	Professional		$64.57	$64.57	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $831.76 / $2,290.87	Professional		$758.58	$831.76	$2,290.87
Quartz Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $758.58 / $4,677.35	Facility		$758.58	$758.58	$4,677.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $758.58 / $758.58	Professional		$758.58	$758.58	$758.58
Security Health Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $977.24 / $1,202.26	Professional		$977.24	$977.24	$1,202.26
United Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $794.33 / $794.33	Facility		$758.58	$794.33	$794.33
United Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $758.58 / $1,174.90	Professional		$758.58	$758.58	$1,174.90