Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $3,890.45 / $6,918.31	Facility		$2,137.96	$3,890.45	$6,918.31
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $1,949.84 / $1,949.84 / $1,949.84	Facility	52	$1,949.84	$1,949.84	$1,949.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $275.42 / $1,258.93	Professional		$67.61	$275.42	$1,258.93
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 $190.55 / $478.63 / $1,380.38	Professional		$190.55	$478.63	$1,380.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $181.97 / $239.88	Facility		$147.91	$181.97	$239.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $457.09 / $776.25	Professional		$363.08	$457.09	$776.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $1,174.90 / $1,905.46	Facility		$1,023.29	$1,174.90	$1,905.46
Cigna Facility/Professional Facility Modifier 22 Low / Median / High Price $275.42 / $275.42 / $275.42	Facility	22	$275.42	$275.42	$275.42
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $186.21 / $186.21 / $186.21	Facility	52	$186.21	$186.21	$186.21
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $46.77 / $46.77 / $46.77	Facility	53	$46.77	$46.77	$46.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $501.19 / $1,479.11	Professional		$181.97	$501.19	$1,479.11
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $363.08 / $2,754.23	Facility		$141.25	$363.08	$2,754.23
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $562.34 / $1,023.29	Professional		$251.19	$562.34	$1,023.29
Medica Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $588.84 / $3,235.94	Facility		$154.88	$588.84	$3,235.94
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $501.19 / $501.19 / $501.19	Facility	52	$501.19	$501.19	$501.19
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $123.03 / $123.03 / $123.03	Facility	53	$123.03	$123.03	$123.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $851.14 / $2,754.23	Professional		$302.00	$851.14	$2,754.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $229.09	Professional		$32.36	$33.11	$229.09
Quartz Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $549.54 / $1,380.38	Professional		$223.87	$549.54	$1,380.38
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 $177.83 / $870.96 / $2,630.27	Professional		$177.83	$870.96	$2,630.27
Security Health Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $1,202.26 / $1,479.11	Professional		$501.19	$1,202.26	$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 $151.36 / $380.19 / $933.25	Professional		$151.36	$380.19	$933.25