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 / $6,918.31	Facility		$218.78	$1,621.81	$6,918.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $380.19 / $831.76	Professional		$91.20	$380.19	$831.76
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,630.27 / $4,570.88 / $7,079.46	Facility		$2,630.27	$4,570.88	$7,079.46
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $398.11 / $1,023.29	Professional		$239.88	$398.11	$1,023.29
CareSource Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $263.03 / $346.74	Facility		$213.80	$263.03	$346.74
CareSource Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $549.54 / $933.25	Professional		$426.58	$549.54	$933.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $1,380.38 / $2,238.72	Facility		$1,174.90	$1,380.38	$2,238.72
Cigna Facility/Professional Facility Modifier 22 Low / Median / High Price $407.38 / $407.38 / $407.38	Facility	22	$407.38	$407.38	$407.38
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $269.15 / $269.15 / $269.15	Facility	52	$269.15	$269.15	$269.15
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $67.61 / $67.61 / $67.61	Facility	53	$67.61	$67.61	$67.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $691.83 / $1,698.24	Professional		$257.04	$691.83	$1,698.24
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $426.58 / $2,884.03	Facility		$204.17	$426.58	$2,884.03
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $724.44 / $1,202.26	Professional		$363.08	$724.44	$1,202.26
Medica Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $489.78 / $3,090.30	Facility		$208.93	$489.78	$3,090.30
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $724.44 / $724.44 / $724.44	Facility	52	$724.44	$724.44	$724.44
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $181.97 / $181.97 / $181.97	Facility	53	$181.97	$181.97	$181.97
Medica Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $954.99 / $3,311.31	Professional		$436.52	$954.99	$3,311.31
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 $316.23 / $645.65 / $1,621.81	Professional		$316.23	$645.65	$1,621.81
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $3,630.78 / $3,630.78	Facility		$2,454.71	$3,630.78	$3,630.78
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $1,949.84 / $1,949.84 / $2,884.03	Facility	52	$1,949.84	$1,949.84	$2,884.03
Quartz Facility/Professional Facility Modifier 53 Low / Median / High Price $489.78 / $489.78 / $724.44	Facility	53	$489.78	$489.78	$724.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $954.99 / $3,162.28	Professional		$251.19	$954.99	$3,162.28
Security Health Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $1,096.48 / $2,238.72	Professional		$724.44	$1,096.48	$2,238.72
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 $218.78 / $467.74 / $1,174.90	Professional		$218.78	$467.74	$1,174.90