Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $2,238.72 / $10,471.29	Facility		$302.00	$2,238.72	$10,471.29
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $457.09 / $1,548.82 / $5,888.44	Facility	50	$457.09	$1,548.82	$5,888.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $323.59 / $812.83	Professional		$173.78	$323.59	$812.83
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $95.50 / $724.44 / $3,388.44	Professional	50	$95.50	$724.44	$3,388.44
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,311.31 / $4,786.30 / $7,585.78	Facility		$3,311.31	$4,786.30	$7,585.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $371.54 / $1,230.27	Professional		$257.04	$371.54	$1,230.27
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $389.05 / $562.34 / $1,819.70	Professional	50	$389.05	$562.34	$1,819.70
CareSource Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $645.65 / $645.65	Professional		$645.65	$645.65	$645.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $912.01 / $1,479.11	Facility		$794.33	$912.01	$1,479.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $616.60 / $1,071.52	Professional		$295.12	$616.60	$1,071.52
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $602.56 / $4,265.80	Facility		$213.80	$602.56	$4,265.80
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $524.81 / $870.96	Professional		$380.19	$524.81	$870.96
DeanCare Facility/Professional Professional Modifier 50 Low / Median / High Price $562.34 / $794.33 / $1,318.26	Professional	50	$562.34	$794.33	$1,318.26
Medica Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $3,162.28 / $8,317.64	Facility		$213.80	$3,162.28	$8,317.64
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $1,479.11 / $2,454.71 / $7,413.10	Facility	50	$1,479.11	$2,454.71	$7,413.10
Medica Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $630.96 / $3,801.89	Professional		$295.12	$630.96	$3,801.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $588.84	Professional		$32.36	$33.11	$588.84
Quartz Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $537.03 / $1,023.29	Professional		$295.12	$537.03	$1,023.29
Quartz Facility/Professional Facility Modifier Low / Median / High Price $5,370.32 / $7,943.28 / $7,943.28	Facility		$5,370.32	$7,943.28	$7,943.28
Quartz Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $645.65 / $3,801.89	Professional		$234.42	$645.65	$3,801.89
Security Health Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $1,047.13 / $1,778.28	Professional		$812.83	$1,047.13	$1,778.28
United Facility/Professional Facility Modifier Low / Median / High Price $4,897.79 / $7,413.10 / $9,120.11	Facility		$4,897.79	$7,413.10	$9,120.11
United Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $524.81 / $1,122.02	Professional		$223.87	$524.81	$1,122.02