Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $323.59 / $501.19	Facility		$81.28	$323.59	$501.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $117.49 / $389.05	Professional		$43.65	$117.49	$389.05
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $3,090.30 / $5,754.40	Facility		$1,584.89	$3,090.30	$5,754.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $91.20 / $245.47	Professional		$58.88	$91.20	$245.47
CareSource Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $47.86 / $67.61	Facility		$38.02	$47.86	$67.61
CareSource Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $79.43 / $107.15	Professional		$79.43	$79.43	$107.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $263.03 / $416.87	Facility		$223.87	$263.03	$416.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $165.96 / $389.05	Professional		$70.79	$165.96	$389.05
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $91.20 / $3,162.28	Facility		$43.65	$91.20	$3,162.28
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $151.36 / $234.42	Professional		$74.13	$151.36	$234.42
Medica Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $117.49 / $1,513.56	Facility		$44.67	$117.49	$1,513.56
Medica Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $169.82 / $616.60	Professional		$85.11	$169.82	$616.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $85.11	Professional		$32.36	$33.11	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $154.88 / $323.59	Professional		$74.13	$154.88	$323.59
Quartz Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $199.53 / $1,698.24	Facility		$107.15	$199.53	$1,698.24
Quartz Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $389.05 / $616.60	Professional		$77.62	$389.05	$616.60
Security Health Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $263.03 / $537.03	Professional		$95.50	$263.03	$537.03
United Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $1,548.82 / $1,949.84	Facility		$977.24	$1,548.82	$1,949.84
United Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $104.71 / $281.84	Professional		$57.54	$104.71	$281.84