Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $1,071.52 / $2,884.03	Facility		$134.90	$1,071.52	$2,884.03
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $912.01 / $2,818.38 / $3,548.13	Facility	50	$912.01	$2,818.38	$3,548.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $218.78 / $741.31	Professional		$102.33	$218.78	$741.31
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $208.93 / $588.84 / $3,162.28	Professional	50	$208.93	$588.84	$3,162.28
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 $154.88 / $239.88 / $537.03	Professional		$154.88	$239.88	$537.03
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $229.09 / $354.81 / $812.83	Professional	50	$229.09	$354.81	$812.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $117.49 / $169.82	Facility		$100.00	$117.49	$169.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $177.83 / $239.88	Professional		$177.83	$177.83	$239.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $602.56 / $954.99	Facility		$512.86	$602.56	$954.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $416.87 / $870.96	Professional		$177.83	$416.87	$870.96
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $223.87 / $3,162.28	Facility		$107.15	$223.87	$3,162.28
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $346.74 / $537.03	Professional		$194.98	$346.74	$537.03
DeanCare Facility/Professional Professional Modifier 50 Low / Median / High Price $295.12 / $512.86 / $794.33	Professional	50	$295.12	$512.86	$794.33
Medica Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $245.47 / $3,630.78	Facility		$117.49	$245.47	$3,630.78
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $977.24 / $2,630.27 / $2,818.38	Facility	50	$977.24	$2,630.27	$2,818.38
Medica Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $407.38 / $3,467.37	Professional		$204.17	$407.38	$3,467.37
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $338.84 / $338.84 / $338.84	Professional	50	$338.84	$338.84	$338.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $147.91	Professional		$32.36	$33.11	$147.91
Quartz Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $331.13 / $676.08	Professional		$181.97	$331.13	$676.08
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,819.70 / $1,819.70 / $2,691.53	Facility		$1,819.70	$1,819.70	$2,691.53
Quartz Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $741.31 / $3,467.37	Professional		$199.53	$741.31	$3,467.37
Security Health Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $676.08 / $1,148.15	Professional		$269.15	$676.08	$1,148.15
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 $117.49 / $257.04 / $707.95	Professional		$117.49	$257.04	$707.95