Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,187.76 / $3,801.89 / $6,918.31	Facility		$2,187.76	$3,801.89	$6,918.31
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $100.00 / $190.55 / $346.74	Facility	53	$100.00	$190.55	$346.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $380.19 / $1,621.81	Professional		$181.97	$380.19	$1,621.81
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $85.11 / $158.49 / $338.84	Professional	53	$85.11	$158.49	$338.84
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 $218.78 / $346.74 / $1,047.13	Professional		$218.78	$346.74	$1,047.13
Anthem BCBS Facility/Professional Professional Modifier 53 Low / Median / High Price $109.65 / $199.53 / $446.68	Professional	53	$109.65	$199.53	$446.68
CareSource Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $177.83 / $323.59	Facility		$27.54	$177.83	$323.59
CareSource Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $91.20 / $467.74	Professional		$48.98	$91.20	$467.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $1,071.52 / $1,698.24	Facility		$912.01	$1,071.52	$1,698.24
Cigna Facility/Professional Facility Modifier 22 Low / Median / High Price $371.54 / $371.54 / $371.54	Facility	22	$371.54	$371.54	$371.54
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $251.19 / $251.19 / $251.19	Facility	52	$251.19	$251.19	$251.19
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $61.66 / $61.66 / $61.66	Facility	53	$61.66	$61.66	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $562.34 / $1,445.44	Professional		$234.42	$562.34	$1,445.44
Cigna Facility/Professional Professional Modifier 53 Low / Median / High Price $177.83 / $218.78 / $338.84	Professional	53	$177.83	$218.78	$338.84
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $354.81 / $2,754.23	Facility		$190.55	$354.81	$2,754.23
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $588.84 / $933.25	Professional		$331.13	$588.84	$933.25
Medica Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $512.86 / $3,548.13	Facility		$204.17	$512.86	$3,548.13
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $660.69 / $660.69 / $660.69	Facility	52	$660.69	$660.69	$660.69
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $165.96 / $165.96 / $165.96	Facility	53	$165.96	$165.96	$165.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $933.25 / $2,754.23	Professional		$354.81	$933.25	$2,754.23
Medica Facility/Professional Professional Modifier 53 Low / Median / High Price $97.72 / $190.55 / $1,122.02	Professional	53	$97.72	$190.55	$1,122.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $288.40	Professional		$32.36	$33.11	$288.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $588.84 / $1,258.93	Professional		$295.12	$588.84	$1,258.93
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $2,754.23 / $2,754.23	Facility		$1,862.09	$2,754.23	$2,754.23
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $1,513.56 / $1,513.56 / $2,238.72	Facility	52	$1,513.56	$1,513.56	$2,238.72
Quartz Facility/Professional Facility Modifier 53 Low / Median / High Price $380.19 / $380.19 / $549.54	Facility	53	$380.19	$380.19	$549.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $794.33 / $2,884.03	Professional		$229.09	$794.33	$2,884.03
Quartz Facility/Professional Professional Modifier 53 Low / Median / High Price $177.83 / $177.83 / $338.84	Professional	53	$177.83	$177.83	$338.84
Security Health Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $1,122.02 / $1,621.81	Professional		$660.69	$1,122.02	$1,621.81
Security Health Facility/Professional Professional Modifier 53 Low / Median / High Price $269.15 / $467.74 / $676.08	Professional	53	$269.15	$467.74	$676.08
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 $204.17 / $398.11 / $977.24	Professional		$204.17	$398.11	$977.24