Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $4,786.30 / $13,489.63	Facility		$912.01	$4,786.30	$13,489.63
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $4,265.80 / $4,265.80 / $11,748.98	Facility	50	$4,265.80	$4,265.80	$11,748.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $645.65 / $2,454.71	Professional		$389.05	$645.65	$2,454.71
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $645.65 / $1,348.96 / $1,949.84	Professional	50	$645.65	$1,348.96	$1,949.84
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,311.31 / $4,786.30 / $7,585.78	Facility		$3,311.31	$4,786.30	$7,585.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $870.96 / $2,089.30	Professional		$426.58	$870.96	$2,089.30
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $630.96 / $1,288.25 / $3,162.28	Professional	50	$630.96	$1,288.25	$3,162.28
CareSource Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $501.19 / $724.44	Facility		$416.87	$501.19	$724.44
CareSource Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $416.87 / $575.44	Professional		$416.87	$416.87	$575.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $1,380.38 / $2,187.76	Facility		$1,174.90	$1,380.38	$2,187.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $1,412.54 / $1,995.26	Professional		$549.54	$1,412.54	$1,995.26
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $407.38 / $630.96 / $3,548.13	Facility		$407.38	$630.96	$3,548.13
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,071.52 / $1,380.38	Professional		$794.33	$1,071.52	$1,380.38
DeanCare Facility/Professional Professional Modifier 50 Low / Median / High Price $1,202.26 / $1,621.81 / $2,089.30	Professional	50	$1,202.26	$1,621.81	$2,089.30
Medica Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $912.01 / $6,918.31	Facility		$436.52	$912.01	$6,918.31
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $3,890.45 / $3,890.45 / $4,466.84	Facility	50	$3,890.45	$3,890.45	$4,466.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $933.25 / $4,168.69	Professional		$446.68	$933.25	$4,168.69
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $5,623.41 / $5,623.41 / $6,165.95	Professional	50	$5,623.41	$5,623.41	$6,165.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $549.54	Professional		$32.36	$33.11	$549.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,148.15 / $1,659.59	Professional		$758.58	$1,148.15	$1,659.59
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,548.13 / $5,248.07 / $5,248.07	Facility		$3,548.13	$5,248.07	$5,248.07
Quartz Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $2,089.30 / $4,168.69	Professional		$724.44	$2,089.30	$4,168.69
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $2,570.40 / $3,019.95	Professional		$1,318.26	$2,570.40	$3,019.95
Security Health Facility/Professional Professional Modifier 50 Low / Median / High Price $5,248.07 / $5,248.07 / $5,248.07	Professional	50	$5,248.07	$5,248.07	$5,248.07
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 $416.87 / $645.65 / $1,778.28	Professional		$416.87	$645.65	$1,778.28