Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $891.25 / $891.25	Facility		$389.05	$891.25	$891.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $263.03 / $389.05	Professional		$239.88	$263.03	$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 $5.01 / $5.89 / $1,122.02	Professional		$5.01	$5.89	$1,122.02
CareSource Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $223.87 / $223.87	Facility		$223.87	$223.87	$223.87
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 / $2,089.30	Facility		$169.82	$707.95	$2,089.30
Medica Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $323.59 / $707.95	Facility		$169.82	$323.59	$707.95
Medica Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $213.80 / $630.96	Professional		$162.18	$213.80	$630.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $64.57 / $489.78	Professional		$54.95	$64.57	$489.78
Quartz Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $758.58 / $1,071.52	Professional		$416.87	$758.58	$1,071.52
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 / $169.82	Professional		$169.82	$169.82	$169.82
Security Health Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $691.83 / $691.83	Professional		$691.83	$691.83	$691.83
Security Health Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,778.28 / $2,454.71	Professional		$933.25	$1,778.28	$2,454.71
United Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $288.40 / $389.05	Facility		$257.04	$288.40	$389.05
United Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $213.80 / $645.65	Professional		$151.36	$213.80	$645.65