Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $1,905.46 / $4,365.16	Facility		$281.84	$1,905.46	$4,365.16
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $870.96 / $2,818.38 / $6,165.95	Facility	50	$870.96	$2,818.38	$6,165.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $199.53 / $676.08	Professional		$87.10	$199.53	$676.08
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $138.04 / $467.74 / $1,659.59	Professional	50	$138.04	$467.74	$1,659.59
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 $131.83 / $204.17 / $457.09	Professional		$131.83	$204.17	$457.09
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $199.53 / $309.03 / $676.08	Professional	50	$199.53	$309.03	$676.08
CareSource Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $102.33 / $147.91	Facility		$85.11	$102.33	$147.91
CareSource Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $165.96 / $218.78	Professional		$165.96	$165.96	$218.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $562.34 / $933.25	Facility		$478.63	$562.34	$933.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $363.08 / $812.83	Professional		$151.36	$363.08	$812.83
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $199.53 / $3,162.28	Facility		$93.33	$199.53	$3,162.28
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $302.00 / $489.78	Professional		$165.96	$302.00	$489.78
DeanCare Facility/Professional Professional Modifier 50 Low / Median / High Price $251.19 / $457.09 / $741.31	Professional	50	$251.19	$457.09	$741.31
DeanCare Facility/Professional Professional Modifier 80 Low / Median / High Price $26.92 / $48.98 / $79.43	Professional	80	$26.92	$48.98	$79.43
Medica Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $229.09 / $3,630.78	Facility		$100.00	$229.09	$3,630.78
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $1,479.11 / $2,570.40 / $3,162.28	Facility	50	$1,479.11	$2,570.40	$3,162.28
Medica Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $363.08 / $3,090.30	Professional		$186.21	$363.08	$3,090.30
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $190.55 / $190.55 / $295.12	Professional	50	$190.55	$190.55	$295.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $123.03	Professional		$32.36	$33.11	$123.03
Quartz Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $302.00 / $630.96	Professional		$158.49	$302.00	$630.96
Quartz Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $1,819.70 / $2,691.53	Facility		$977.24	$1,819.70	$2,691.53
Quartz Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $676.08 / $3,090.30	Professional		$173.78	$676.08	$3,090.30
Security Health Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $588.84 / $1,047.13	Professional		$234.42	$588.84	$1,047.13
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 $97.72 / $234.42 / $630.96	Professional		$97.72	$234.42	$630.96