Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $288.40 / $758.58	Facility		$93.33	$288.40	$758.58
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $891.25 / $3,162.28 / $3,162.28	Facility	50	$891.25	$3,162.28	$3,162.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $177.83 / $512.86	Professional		$56.23	$177.83	$512.86
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $81.28 / $512.86 / $1,023.29	Professional	50	$81.28	$512.86	$1,023.29
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 $81.28 / $131.83 / $263.03	Professional		$81.28	$131.83	$263.03
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $120.23 / $199.53 / $398.11	Professional	50	$120.23	$199.53	$398.11
CareSource Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $331.13 / $331.13	Professional		$331.13	$331.13	$331.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $489.78 / $776.25	Facility		$416.87	$489.78	$776.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $194.98 / $562.34	Professional		$89.13	$194.98	$562.34
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $245.47 / $3,715.35	Facility		$64.57	$245.47	$3,715.35
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $186.21 / $436.52	Professional		$117.49	$186.21	$436.52
DeanCare Facility/Professional Professional Modifier 50 Low / Median / High Price $177.83 / $275.42 / $660.69	Professional	50	$177.83	$275.42	$660.69
Medica Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $263.03 / $1,778.28	Facility		$64.57	$263.03	$1,778.28
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $102.33 / $186.21 / $575.44	Facility	50	$102.33	$186.21	$575.44
Medica Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $213.80 / $1,148.15	Professional		$117.49	$213.80	$1,148.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $128.82	Professional		$32.36	$33.11	$128.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $213.80 / $549.54	Professional		$97.72	$213.80	$549.54
Quartz Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $1,288.25 / $1,288.25	Facility		$181.97	$1,288.25	$1,288.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $309.03 / $1,122.02	Professional		$74.13	$309.03	$1,122.02
Security Health Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $331.13 / $933.25	Professional		$141.25	$331.13	$933.25
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 $64.57 / $162.18 / $501.19	Professional		$64.57	$162.18	$501.19