Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $891.25 / $1,698.24	Facility		$64.57	$891.25	$1,698.24
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $537.03 / $537.03 / $537.03	Facility	52	$537.03	$537.03	$537.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $162.18 / $645.65	Professional		$61.66	$162.18	$645.65
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $3,090.30 / $5,754.40	Facility		$1,584.89	$3,090.30	$5,754.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $144.54 / $354.81	Professional		$89.13	$144.54	$354.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $74.13 / $74.13	Facility		$74.13	$74.13	$74.13
CareSource Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $181.97 / $181.97	Professional		$181.97	$181.97	$181.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $446.68 / $758.58	Facility		$389.05	$446.68	$758.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $269.15 / $616.60	Professional		$102.33	$269.15	$616.60
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $147.91 / $3,162.28	Facility		$63.10	$147.91	$3,162.28
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $257.04 / $398.11	Professional		$112.20	$257.04	$398.11
Medica Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $165.96 / $3,311.31	Facility		$63.10	$165.96	$3,311.31
Medica Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $295.12 / $1,148.15	Professional		$154.88	$295.12	$1,148.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $154.88	Professional		$32.36	$33.11	$154.88
Quartz Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $257.04 / $549.54	Professional		$114.82	$257.04	$549.54
Quartz Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $1,445.44 / $2,089.30	Facility		$758.58	$1,445.44	$2,089.30
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $1,148.15 / $1,148.15 / $1,698.24	Facility	52	$1,148.15	$1,148.15	$1,698.24
Quartz Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $676.08 / $1,174.90	Professional		$128.82	$676.08	$1,174.90
Security Health Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $426.58 / $851.14	Professional		$281.84	$426.58	$851.14
United Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $2,818.38 / $4,677.35	Facility		$2,238.72	$2,818.38	$4,677.35
United Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $181.97 / $501.19	Professional		$81.28	$181.97	$501.19