Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $323.59 / $2,454.71	Facility		$67.61	$323.59	$2,454.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $147.91 / $354.81	Professional		$66.07	$147.91	$354.81
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $208.93 / $426.58 / $1,230.27	Professional	50	$208.93	$426.58	$1,230.27
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 $97.72 / $154.88 / $331.13	Professional		$97.72	$154.88	$331.13
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $158.49 / $229.09 / $489.78	Professional	50	$158.49	$229.09	$489.78
CareSource Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $81.28 / $117.49	Facility		$67.61	$81.28	$117.49
CareSource Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $144.54 / $194.98	Professional		$144.54	$144.54	$194.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $501.19 / $794.33	Facility		$426.58	$501.19	$794.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $295.12 / $724.44	Professional		$117.49	$295.12	$724.44
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $162.18 / $3,162.28	Facility		$67.61	$162.18	$3,162.28
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $239.88 / $436.52	Professional		$131.83	$239.88	$436.52
DeanCare Facility/Professional Professional Modifier 50 Low / Median / High Price $199.53 / $354.81 / $645.65	Professional	50	$199.53	$354.81	$645.65
Medica Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $173.78 / $3,019.95	Facility		$70.79	$173.78	$3,019.95
Medica Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $269.15 / $1,174.90	Professional		$138.04	$269.15	$1,174.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $97.72	Professional		$32.36	$33.11	$97.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $275.42 / $575.44	Professional		$128.82	$275.42	$575.44
Quartz Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $2,398.83 / $2,398.83	Facility		$389.05	$2,398.83	$2,398.83
Quartz Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $645.65 / $1,122.02	Professional		$134.90	$645.65	$1,122.02
Security Health Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $416.87 / $933.25	Professional		$234.42	$416.87	$933.25
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 $75.86 / $165.96 / $457.09	Professional		$75.86	$165.96	$457.09