Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $1,548.82 / $3,467.37	Facility		$794.33	$1,548.82	$3,467.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $776.25 / $1,258.93	Professional		$724.44	$776.25	$1,258.93
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $977.24 / $1,737.80	Facility		$977.24	$977.24	$1,737.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $776.25 / $977.24	Professional		$776.25	$776.25	$977.24
CareSource Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $1,000.00 / $1,380.38	Facility		$741.31	$1,000.00	$1,380.38
CareSource Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $954.99 / $1,698.24	Professional		$741.31	$954.99	$1,698.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $1,023.29 / $1,862.09	Facility		$776.25	$1,023.29	$1,862.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $812.83 / $1,584.89	Professional		$776.25	$812.83	$1,584.89
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $741.31 / $1,047.13	Facility		$457.09	$741.31	$1,047.13
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $1,412.54 / $1,479.11	Professional		$134.90	$1,412.54	$1,479.11
Medica Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $741.31 / $1,380.38	Facility		$501.19	$741.31	$1,380.38
Medica Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $812.83 / $3,090.30	Professional		$741.31	$812.83	$3,090.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $64.57 / $85.11	Professional		$50.12	$64.57	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,318.26 / $2,398.83	Professional		$776.25	$1,318.26	$2,398.83
Quartz Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $776.25 / $3,630.78	Facility		$776.25	$776.25	$3,630.78
Quartz Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,288.25 / $3,090.30	Professional		$776.25	$1,288.25	$3,090.30
Security Health Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $776.25 / $1,288.25	Professional		$562.34	$776.25	$1,288.25
United Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $707.95 / $776.25	Facility		$707.95	$707.95	$776.25
United Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $831.76 / $933.25	Professional		$776.25	$831.76	$933.25