Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $1,698.24 / $2,290.87	Facility		$269.15	$1,698.24	$2,290.87
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,884.03 / $2,884.03 / $9,120.11	Facility	50	$2,884.03	$2,884.03	$9,120.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $269.15 / $776.25	Professional		$125.89	$269.15	$776.25
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $288.40 / $831.76 / $2,511.89	Professional	50	$288.40	$831.76	$2,511.89
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 $190.55 / $295.12 / $660.69	Professional		$190.55	$295.12	$660.69
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $288.40 / $446.68 / $1,000.00	Professional	50	$288.40	$446.68	$1,000.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $831.76 / $1,348.96	Facility		$724.44	$831.76	$1,348.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $512.86 / $1,202.26	Professional		$213.80	$512.86	$1,202.26
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $275.42 / $3,162.28	Facility		$120.23	$275.42	$3,162.28
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $446.68 / $741.31	Professional		$239.88	$446.68	$741.31
DeanCare Facility/Professional Professional Modifier 50 Low / Median / High Price $363.08 / $676.08 / $1,096.48	Professional	50	$363.08	$676.08	$1,096.48
Medica Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $302.00 / $3,311.31	Facility		$120.23	$302.00	$3,311.31
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $2,754.23 / $2,754.23 / $2,754.23	Facility	50	$2,754.23	$2,754.23	$2,754.23
Medica Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $524.81 / $1,995.26	Professional		$275.42	$524.81	$1,995.26
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $416.87 / $416.87 / $416.87	Professional	50	$416.87	$416.87	$416.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $177.83	Professional		$32.36	$33.11	$177.83
Quartz Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $446.68 / $933.25	Professional		$229.09	$446.68	$933.25
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,819.70 / $2,691.53 / $2,691.53	Facility		$1,819.70	$2,691.53	$2,691.53
Quartz Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $1,230.27 / $2,041.74	Professional		$275.42	$1,230.27	$2,041.74
Security Health Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $831.76 / $1,584.89	Professional		$398.11	$831.76	$1,584.89
United Facility/Professional Facility Modifier Low / Median / High Price $2,344.23 / $2,818.38 / $4,677.35	Facility		$2,344.23	$2,818.38	$4,677.35
United Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $331.13 / $891.25	Professional		$141.25	$331.13	$891.25