Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $537.03 / $1,905.46	Facility		$123.03	$537.03	$1,905.46
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,096.48 / $1,096.48 / $1,096.48	Facility	50	$1,096.48	$1,096.48	$1,096.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $213.80 / $660.69	Professional		$66.07	$213.80	$660.69
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $147.91 / $616.60 / $1,148.15	Professional	50	$147.91	$616.60	$1,148.15
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $1,584.89 / $1,584.89	Facility		$1,202.26	$1,584.89	$1,584.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $154.88 / $389.05	Professional		$85.11	$154.88	$389.05
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $134.90 / $251.19 / $575.44	Professional	50	$134.90	$251.19	$575.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $89.13 / $120.23	Facility		$85.11	$89.13	$120.23
CareSource Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $275.42 / $281.84	Professional		$194.98	$275.42	$281.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $724.44 / $1,174.90	Facility		$630.96	$724.44	$1,174.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $275.42 / $1,071.52	Professional		$83.18	$275.42	$1,071.52
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $223.87 / $2,818.38	Facility		$66.07	$223.87	$2,818.38
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $229.09 / $630.96	Professional		$131.83	$229.09	$630.96
DeanCare Facility/Professional Professional Modifier 50 Low / Median / High Price $194.98 / $346.74 / $933.25	Professional	50	$194.98	$346.74	$933.25
Medica Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $245.47 / $1,445.44	Facility		$70.79	$245.47	$1,445.44
Medica Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $691.83 / $3,235.94	Professional		$223.87	$691.83	$3,235.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $93.33	Professional		$32.36	$33.11	$93.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $275.42 / $758.58	Professional		$112.20	$275.42	$758.58
Quartz Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $2,951.21 / $2,951.21	Facility		$346.74	$2,951.21	$2,951.21
Quartz Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $1,071.52 / $3,311.31	Professional		$120.23	$1,071.52	$3,311.31
Security Health Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $457.09 / $1,479.11	Professional		$229.09	$457.09	$1,479.11
United Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $1,584.89 / $1,949.84	Facility		$1,023.29	$1,584.89	$1,949.84
United Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $245.47 / $794.33	Professional		$81.28	$245.47	$794.33