Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $1,621.81 / $2,137.96	Facility		$218.78	$1,621.81	$2,137.96
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,019.95 / $3,019.95 / $3,019.95	Facility	50	$3,019.95	$3,019.95	$3,019.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $269.15 / $794.33	Professional		$100.00	$269.15	$794.33
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 $173.78 / $446.68 / $1,202.26	Professional		$173.78	$446.68	$1,202.26
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 $851.14 / $977.24 / $1,584.89	Facility		$851.14	$977.24	$1,584.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $416.87 / $1,122.02	Professional		$186.21	$416.87	$1,122.02
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $645.65 / $3,801.89	Facility		$131.83	$645.65	$3,801.89
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $363.08 / $912.01	Professional		$229.09	$363.08	$912.01
Medica Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $1,584.89 / $4,168.69	Facility		$131.83	$1,584.89	$4,168.69
Medica Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $933.25 / $2,137.96	Professional		$316.23	$933.25	$2,137.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $331.13	Professional		$32.36	$33.11	$331.13
Quartz Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $407.38 / $1,071.52	Professional		$181.97	$407.38	$1,071.52
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $1,288.25 / $1,905.46	Facility		$1,288.25	$1,288.25	$1,905.46
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $1,023.29 / $1,023.29 / $1,513.56	Facility	52	$1,023.29	$1,023.29	$1,513.56
Quartz Facility/Professional Facility Modifier 53 Low / Median / High Price $257.04 / $257.04 / $380.19	Facility	53	$257.04	$257.04	$380.19
Quartz Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $588.84 / $2,884.03	Professional		$186.21	$588.84	$2,884.03
Security Health Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $660.69 / $1,905.46	Professional		$478.63	$660.69	$1,905.46
United Facility/Professional Facility Modifier Low / Median / High Price $2,187.76 / $2,818.38 / $4,677.35	Facility		$2,187.76	$2,818.38	$4,677.35
United Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $416.87 / $1,230.27	Professional		$131.83	$416.87	$1,230.27