Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $2,884.03 / $5,495.41	Facility		$229.09	$2,884.03	$5,495.41
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,951.21 / $2,951.21 / $3,467.37	Facility	50	$2,951.21	$2,951.21	$3,467.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $223.87 / $977.24	Professional		$57.54	$223.87	$977.24
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $85.11 / $218.78 / $1,148.15	Professional	50	$85.11	$218.78	$1,148.15
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $1,584.89 / $6,165.95	Facility		$1,202.26	$1,584.89	$6,165.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $151.36 / $309.03	Professional		$87.10	$151.36	$309.03
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $128.82 / $229.09 / $457.09	Professional	50	$128.82	$229.09	$457.09
CareSource Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $66.07 / $95.50	Facility		$54.95	$66.07	$95.50
CareSource Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $218.78 / $281.84	Professional		$218.78	$218.78	$281.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $758.58 / $1,230.27	Facility		$660.69	$758.58	$1,230.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $263.03 / $1,023.29	Professional		$97.72	$263.03	$1,023.29
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $234.42 / $3,162.28	Facility		$60.26	$234.42	$3,162.28
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $199.53 / $630.96	Professional		$107.15	$199.53	$630.96
DeanCare Facility/Professional Professional Modifier 50 Low / Median / High Price $162.18 / $302.00 / $933.25	Professional	50	$162.18	$302.00	$933.25
Medica Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $275.42 / $1,737.80	Facility		$60.26	$275.42	$1,737.80
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $776.25 / $1,047.13 / $3,630.78	Facility	50	$776.25	$1,047.13	$3,630.78
Medica Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $331.13 / $1,778.28	Professional		$186.21	$331.13	$1,778.28
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $812.83 / $812.83 / $812.83	Professional	50	$812.83	$812.83	$812.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $85.11	Professional		$32.36	$33.11	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $281.84 / $831.76	Professional		$97.72	$281.84	$831.76
Quartz Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $151.36 / $724.44	Facility		$151.36	$151.36	$724.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $588.84 / $1,698.24	Professional		$112.20	$588.84	$1,698.24
Security Health Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $389.05 / $1,412.54	Professional		$275.42	$389.05	$1,412.54
United Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $1,584.89 / $1,949.84	Facility		$1,023.29	$1,584.89	$1,949.84
United Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $213.80 / $602.56	Professional		$70.79	$213.80	$602.56