Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $3,019.95 / $6,456.54	Facility		$371.54	$3,019.95	$6,456.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $263.03 / $891.25	Professional		$112.20	$263.03	$891.25
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $3,090.30 / $5,754.40	Facility		$2,238.72	$3,090.30	$5,754.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $389.05 / $1,122.02	Professional		$169.82	$389.05	$1,122.02
CareSource Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $162.18 / $213.80	Facility		$128.82	$162.18	$213.80
CareSource Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $354.81 / $602.56	Professional		$275.42	$354.81	$602.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $912.01 / $1,445.44	Facility		$776.25	$912.01	$1,445.44
Cigna Facility/Professional Facility Modifier 22 Low / Median / High Price $245.47 / $245.47 / $245.47	Facility	22	$245.47	$245.47	$245.47
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $165.96 / $165.96 / $165.96	Facility	52	$165.96	$165.96	$165.96
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $41.69 / $41.69 / $41.69	Facility	53	$41.69	$41.69	$41.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $446.68 / $1,096.48	Professional		$154.88	$446.68	$1,096.48
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $281.84 / $2,238.72	Facility		$123.03	$281.84	$2,238.72
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $467.74 / $794.33	Professional		$218.78	$467.74	$794.33
Medica Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $323.59 / $3,090.30	Facility		$128.82	$323.59	$3,090.30
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $446.68 / $446.68 / $446.68	Facility	52	$446.68	$446.68	$446.68
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $109.65 / $109.65 / $109.65	Facility	53	$109.65	$109.65	$109.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $741.31 / $2,137.96	Professional		$288.40	$741.31	$2,137.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $194.98	Professional		$32.36	$33.11	$194.98
Quartz Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $426.58 / $1,071.52	Professional		$199.53	$426.58	$1,071.52
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $2,884.03 / $2,884.03	Facility		$1,949.84	$2,884.03	$2,884.03
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $1,548.82 / $1,548.82 / $2,290.87	Facility	52	$1,548.82	$1,548.82	$2,290.87
Quartz Facility/Professional Facility Modifier 53 Low / Median / High Price $389.05 / $389.05 / $575.44	Facility	53	$389.05	$389.05	$575.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $676.08 / $2,041.74	Professional		$154.88	$676.08	$2,041.74
Security Health Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $691.83 / $1,479.11	Professional		$446.68	$691.83	$1,479.11
United Facility/Professional Facility Modifier Low / Median / High Price $2,884.03 / $3,630.78 / $6,456.54	Facility		$2,884.03	$3,630.78	$6,456.54
United Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $302.00 / $758.58	Professional		$134.90	$302.00	$758.58