Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $218.78 / $524.81	Facility		$56.23	$218.78	$524.81
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $416.87 / $707.95 / $794.33	Facility	50	$416.87	$707.95	$794.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $77.62 / $177.83	Professional		$25.12	$77.62	$177.83
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $38.02 / $234.42 / $512.86	Professional	50	$38.02	$234.42	$512.86
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $3,090.30 / $5,754.40	Facility		$1,380.38	$3,090.30	$5,754.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $63.10 / $138.04	Professional		$34.67	$63.10	$138.04
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $52.48 / $95.50 / $204.17	Professional	50	$52.48	$95.50	$204.17
CareSource Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $30.20 / $42.66	Facility		$25.70	$30.20	$42.66
CareSource Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $81.28 / $107.15	Professional		$81.28	$81.28	$107.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $281.84 / $446.68	Facility		$239.88	$281.84	$446.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $128.82 / $416.87	Professional		$44.67	$128.82	$416.87
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $102.33 / $3,162.28	Facility		$28.18	$102.33	$3,162.28
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $91.20 / $239.88	Professional		$50.12	$91.20	$239.88
DeanCare Facility/Professional Professional Modifier 50 Low / Median / High Price $75.86 / $138.04 / $354.81	Professional	50	$75.86	$138.04	$354.81
Medica Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $114.82 / $1,584.89	Facility		$31.62	$114.82	$1,584.89
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $245.47 / $245.47 / $245.47	Facility	50	$245.47	$245.47	$245.47
Medica Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $154.88 / $660.69	Professional		$83.18	$154.88	$660.69
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 $44.67 / $114.82 / $275.42	Professional		$44.67	$114.82	$275.42
Quartz Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $251.19 / $363.08	Facility		$131.83	$251.19	$363.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $338.84 / $630.96	Professional		$50.12	$338.84	$630.96
Security Health Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $190.55 / $575.44	Professional		$91.20	$190.55	$575.44
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 $25.70 / $93.33 / $295.12	Professional		$25.70	$93.33	$295.12