Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $2,290.87 / $5,888.44	Facility		$416.87	$2,290.87	$5,888.44
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,819.70 / $3,801.89 / $8,511.38	Facility	50	$1,819.70	$3,801.89	$8,511.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $446.68 / $1,862.09	Professional		$186.21	$446.68	$1,862.09
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $275.42 / $707.95 / $3,090.30	Professional	50	$275.42	$707.95	$3,090.30
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,630.27 / $4,570.88 / $7,079.46	Facility		$2,630.27	$4,570.88	$7,079.46
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $436.52 / $1,071.52	Professional		$281.84	$436.52	$1,071.52
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $416.87 / $645.65 / $1,621.81	Professional	50	$416.87	$645.65	$1,621.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $218.78 / $309.03	Facility		$181.97	$218.78	$309.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $407.38 / $537.03	Professional		$407.38	$407.38	$537.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $1,412.54 / $2,238.72	Facility		$1,202.26	$1,412.54	$2,238.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $812.83 / $1,995.26	Professional		$323.59	$812.83	$1,995.26
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $489.78 / $3,162.28	Facility		$208.93	$489.78	$3,162.28
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $758.58 / $1,202.26	Professional		$354.81	$758.58	$1,202.26
DeanCare Facility/Professional Professional Modifier 50 Low / Median / High Price $537.03 / $1,122.02 / $1,819.70	Professional	50	$537.03	$1,122.02	$1,819.70
Medica Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $562.34 / $7,244.36	Facility		$229.09	$562.34	$7,244.36
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $2,511.89 / $6,606.93 / $8,317.64	Facility	50	$2,511.89	$6,606.93	$8,317.64
Medica Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $812.83 / $3,311.31	Professional		$446.68	$812.83	$3,311.31
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $2,238.72 / $2,238.72 / $2,238.72	Professional	50	$2,238.72	$2,238.72	$2,238.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $309.03	Professional		$32.36	$33.11	$309.03
Quartz Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $741.31 / $1,548.82	Professional		$338.84	$741.31	$1,548.82
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,905.46 / $3,548.13 / $5,248.07	Facility		$1,905.46	$3,548.13	$5,248.07
Quartz Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $1,096.48 / $3,162.28	Professional		$371.54	$1,096.48	$3,162.28
Security Health Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $1,445.44 / $2,630.27	Professional		$741.31	$1,445.44	$2,630.27
United Facility/Professional Facility Modifier Low / Median / High Price $4,897.79 / $7,413.10 / $9,120.11	Facility		$4,897.79	$7,413.10	$9,120.11
United Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $549.54 / $1,479.11	Professional		$257.04	$549.54	$1,479.11