Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $691.83 / $1,023.29	Facility		$371.54	$691.83	$1,023.29
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $851.14 / $851.14 / $851.14	Facility	50	$851.14	$851.14	$851.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $316.23 / $812.83	Professional		$218.78	$316.23	$812.83
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $354.81 / $912.01 / $1,862.09	Professional	50	$354.81	$912.01	$1,862.09
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 $239.88 / $398.11 / $1,122.02	Professional		$239.88	$398.11	$1,122.02
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $363.08 / $588.84 / $1,659.59	Professional	50	$363.08	$588.84	$1,659.59
CareSource Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $257.04 / $257.04	Facility		$257.04	$257.04	$257.04
CareSource Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $309.03 / $309.03	Professional		$309.03	$309.03	$309.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $758.58 / $1,230.27	Facility		$645.65	$758.58	$1,230.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $549.54 / $912.01	Professional		$281.84	$549.54	$912.01
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $426.58 / $6,456.54	Facility		$234.42	$426.58	$6,456.54
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $549.54 / $676.08	Professional		$426.58	$549.54	$676.08
DeanCare Facility/Professional Professional Modifier 50 Low / Median / High Price $645.65 / $812.83 / $1,023.29	Professional	50	$645.65	$812.83	$1,023.29
DeanCare Facility/Professional Professional Modifier 54 Low / Median / High Price $346.74 / $436.52 / $537.03	Professional	54	$346.74	$436.52	$537.03
DeanCare Facility/Professional Professional Modifier 55 Low / Median / High Price $85.11 / $109.65 / $134.90	Professional	55	$85.11	$109.65	$134.90
Medica Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $446.68 / $3,981.07	Facility		$234.42	$446.68	$3,981.07
Medica Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $602.56 / $4,466.84	Professional		$275.42	$602.56	$4,466.84
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $537.03 / $537.03 / $537.03	Professional	50	$537.03	$537.03	$537.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $446.68	Professional		$32.36	$33.11	$446.68
Quartz Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $537.03 / $812.83	Professional		$275.42	$537.03	$812.83
Quartz Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $2,951.21 / $2,951.21	Facility		$537.03	$2,951.21	$2,951.21
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $371.54 / $977.24 / $977.24	Facility	54	$371.54	$977.24	$977.24
Quartz Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $891.25 / $4,466.84	Professional		$309.03	$891.25	$4,466.84
Security Health Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $416.87 / $416.87	Facility		$416.87	$416.87	$416.87
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,995.26 / $2,398.83	Professional		$1,096.48	$1,995.26	$2,398.83
United Facility/Professional Facility Modifier Low / Median / High Price $2,041.74 / $2,818.38 / $4,677.35	Facility		$2,041.74	$2,818.38	$4,677.35
United Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $407.38 / $1,023.29	Professional		$239.88	$407.38	$1,023.29