Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $104.71 / $1,905.46	Facility		$30.90	$104.71	$1,905.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $66.07 / $194.98	Professional		$33.11	$66.07	$194.98
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $102.33 / $190.55 / $363.08	Professional	50	$102.33	$190.55	$363.08
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 $44.67 / $66.07 / $165.96	Professional		$44.67	$66.07	$165.96
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $69.18 / $102.33 / $245.47	Professional	50	$69.18	$102.33	$245.47
CareSource Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $38.02 / $53.70	Facility		$31.62	$38.02	$53.70
CareSource Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $46.77 / $63.10	Professional		$46.77	$46.77	$63.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $154.88 / $251.19	Facility		$134.90	$154.88	$251.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $125.89 / $229.09	Professional		$53.70	$125.89	$229.09
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $66.07 / $3,162.28	Facility		$34.67	$66.07	$3,162.28
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $91.20 / $138.04	Professional		$61.66	$91.20	$138.04
DeanCare Facility/Professional Professional Modifier 50 Low / Median / High Price $91.20 / $138.04 / $208.93	Professional	50	$91.20	$138.04	$208.93
Medica Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $69.18 / $1,659.59	Facility		$35.48	$69.18	$1,659.59
Medica Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $95.50 / $380.19	Professional		$52.48	$95.50	$380.19
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $199.53 / $199.53 / $446.68	Professional	50	$199.53	$199.53	$446.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $70.79	Professional		$32.36	$33.11	$70.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $100.00 / $165.96	Professional		$58.88	$100.00	$165.96
Quartz Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $87.10 / $208.93	Facility		$45.71	$87.10	$208.93
Quartz Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $190.55 / $363.08	Professional		$61.66	$190.55	$363.08
Security Health Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $194.98 / $295.12	Professional		$95.50	$194.98	$295.12
United Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $1,548.82 / $1,949.84	Facility		$1,023.29	$1,548.82	$1,949.84
United Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $67.61 / $173.78	Professional		$40.74	$67.61	$173.78