Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $4,365.16 / $6,918.31	Facility		$588.84	$4,365.16	$6,918.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $457.09 / $1,412.54	Professional		$245.47	$457.09	$1,412.54
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $109.65 / $169.82 / $467.74	Professional	53	$109.65	$169.82	$467.74
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 $302.00 / $478.63 / $1,445.44	Professional		$302.00	$478.63	$1,445.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $331.13 / $436.52	Facility		$269.15	$331.13	$436.52
CareSource Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $562.34 / $977.24	Professional		$436.52	$562.34	$977.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $1,412.54 / $2,238.72	Facility		$1,202.26	$1,412.54	$2,238.72
Cigna Facility/Professional Facility Modifier 22 Low / Median / High Price $512.86 / $512.86 / $512.86	Facility	22	$512.86	$512.86	$512.86
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $338.84 / $338.84 / $338.84	Facility	52	$338.84	$338.84	$338.84
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $85.11 / $85.11 / $85.11	Facility	53	$85.11	$85.11	$85.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $741.31 / $1,905.46	Professional		$316.23	$741.31	$1,905.46
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $478.63 / $2,884.03	Facility		$263.03	$478.63	$2,884.03
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $794.33 / $1,230.27	Professional		$457.09	$794.33	$1,230.27
Medica Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $912.01 / $3,630.78	Facility		$288.40	$912.01	$3,630.78
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $912.01 / $912.01 / $912.01	Facility	52	$912.01	$912.01	$912.01
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $229.09 / $229.09 / $229.09	Facility	53	$229.09	$229.09	$229.09
Medica Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $1,380.38 / $3,467.37	Professional		$467.74	$1,380.38	$3,467.37
Medica Facility/Professional Professional Modifier 53 Low / Median / High Price $1,318.26 / $1,318.26 / $1,737.80	Professional	53	$1,318.26	$1,318.26	$1,737.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $407.38	Professional		$32.36	$33.11	$407.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $794.33 / $1,659.59	Professional		$398.11	$794.33	$1,659.59
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 $316.23 / $1,047.13 / $3,548.13	Professional		$316.23	$1,047.13	$3,548.13
Security Health Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,479.11 / $2,344.23	Professional		$912.01	$1,479.11	$2,344.23
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 $275.42 / $537.03 / $1,348.96	Professional		$275.42	$537.03	$1,348.96