Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $7,413.10 / $16,595.87 / $29,512.09	Facility		$7,413.10	$16,595.87	$29,512.09
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $26,915.35 / $44,668.36 / $44,668.36	Facility	50	$26,915.35	$44,668.36	$44,668.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $1,949.84 / $7,585.78	Professional		$588.84	$1,949.84	$7,585.78
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $169.82 / $446.68 / $1,445.44	Professional	AS	$169.82	$446.68	$1,445.44
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $12,882.50 / $18,197.01 / $28,840.32	Facility		$12,882.50	$18,197.01	$28,840.32
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $2,570.40 / $6,606.93	Professional		$1,288.25	$2,570.40	$6,606.93
Anthem BCBS Facility/Professional Professional Modifier AS Low / Median / High Price $181.97 / $389.05 / $954.99	Professional	AS	$181.97	$389.05	$954.99
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $1,445.44 / $2,089.30	Facility		$1,174.90	$1,445.44	$2,089.30
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,202.26 / $1,659.59	Professional		$1,202.26	$1,202.26	$1,659.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,235.94 / $3,801.89 / $6,309.57	Facility		$3,235.94	$3,801.89	$6,309.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,698.24 / $5,128.61 / $5,754.40	Professional		$1,698.24	$5,128.61	$5,754.40
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $2,754.23 / $10,471.29	Facility		$1,288.25	$2,754.23	$10,471.29
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $2,238.72 / $3,019.95 / $3,890.45	Professional		$2,238.72	$3,019.95	$3,890.45
DeanCare Facility/Professional Professional Modifier AS Low / Median / High Price $316.23 / $426.58 / $549.54	Professional	AS	$316.23	$426.58	$549.54
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,445.44 / $8,709.64 / $19,952.62	Facility		$1,445.44	$8,709.64	$19,952.62
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $10,715.19 / $10,715.19 / $10,715.19	Facility	50	$10,715.19	$10,715.19	$10,715.19
Medica Facility/Professional Facility Modifier AS Low / Median / High Price $5,623.41 / $5,623.41 / $5,623.41	Facility	AS	$5,623.41	$5,623.41	$5,623.41
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $2,691.53 / $11,220.18	Professional		$1,479.11	$2,691.53	$11,220.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $70.79	Professional		$32.36	$33.11	$70.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $2,754.23 / $4,265.80	Professional		$1,819.70	$2,754.23	$4,265.80
Quartz Facility/Professional Facility Modifier Low / Median / High Price $19,054.61 / $35,481.34 / $52,480.75	Facility		$19,054.61	$35,481.34	$52,480.75
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $25,118.86 / $25,118.86 / $37,153.52	Facility	54	$25,118.86	$25,118.86	$37,153.52
Quartz Facility/Professional Facility Modifier AS Low / Median / High Price $3,548.13 / $3,548.13 / $5,248.07	Facility	AS	$3,548.13	$3,548.13	$5,248.07
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,238.72 / $6,456.54 / $11,220.18	Professional		$2,238.72	$6,456.54	$11,220.18
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,365.16 / $6,918.31 / $10,471.29	Professional		$4,365.16	$6,918.31	$10,471.29
United Facility/Professional Facility Modifier Low / Median / High Price $8,709.64 / $18,197.01 / $28,840.32	Facility		$8,709.64	$18,197.01	$28,840.32
United Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $2,137.96 / $5,495.41	Professional		$1,412.54	$2,137.96	$5,495.41