Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $1,698.24 / $7,585.78	Facility		$109.65	$1,698.24	$7,585.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $114.82 / $676.08	Professional		$58.88	$114.82	$676.08
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $60.26 / $338.84 / $1,071.52	Professional	50	$60.26	$338.84	$1,071.52
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 $91.20 / $144.54 / $295.12	Professional		$91.20	$144.54	$295.12
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $138.04 / $213.80 / $436.52	Professional	50	$138.04	$213.80	$436.52
CareSource Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $72.44 / $102.33	Facility		$60.26	$72.44	$102.33
CareSource Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $144.54	Professional		$109.65	$109.65	$144.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $363.08 / $575.44	Facility		$309.03	$363.08	$575.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $251.19 / $524.81	Professional		$102.33	$251.19	$524.81
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $128.82 / $3,162.28	Facility		$61.66	$128.82	$3,162.28
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $208.93 / $323.59	Professional		$117.49	$208.93	$323.59
DeanCare Facility/Professional Professional Modifier 50 Low / Median / High Price $173.78 / $309.03 / $478.63	Professional	50	$173.78	$309.03	$478.63
Medica Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $165.96 / $3,630.78	Facility		$69.18	$165.96	$3,630.78
Medica Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $199.53 / $1,096.48	Professional		$85.11	$199.53	$1,096.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $89.13	Professional		$32.36	$33.11	$89.13
Quartz Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $218.78 / $446.68	Professional		$117.49	$218.78	$446.68
Quartz Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $251.19 / $1,288.25	Facility		$134.90	$251.19	$1,288.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $478.63 / $1,096.48	Professional		$120.23	$478.63	$1,096.48
Security Health Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $363.08 / $691.83	Professional		$190.55	$363.08	$691.83
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 $69.18 / $131.83 / $363.08	Professional		$69.18	$131.83	$363.08