Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $354.81 / $691.83 / $1,096.48	Facility		$354.81	$691.83	$1,096.48
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $524.81 / $524.81 / $524.81	Facility	50	$524.81	$524.81	$524.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $354.81 / $954.99	Professional		$234.42	$354.81	$954.99
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $446.68 / $1,621.81 / $2,691.53	Professional	50	$446.68	$1,621.81	$2,691.53
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 $295.12 / $457.09 / $1,122.02	Professional		$295.12	$457.09	$1,122.02
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $436.52 / $691.83 / $1,698.24	Professional	50	$436.52	$691.83	$1,698.24
CareSource Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $363.08 / $363.08	Professional		$363.08	$363.08	$363.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $933.25 / $1,479.11	Facility		$794.33	$933.25	$1,479.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $660.69 / $1,096.48	Professional		$281.84	$660.69	$1,096.48
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $501.19 / $3,548.13	Facility		$275.42	$501.19	$3,548.13
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $645.65 / $812.83	Professional		$501.19	$645.65	$812.83
DeanCare Facility/Professional Professional Modifier 50 Low / Median / High Price $758.58 / $954.99 / $1,230.27	Professional	50	$758.58	$954.99	$1,230.27
DeanCare Facility/Professional Professional Modifier 54 Low / Median / High Price $407.38 / $512.86 / $660.69	Professional	54	$407.38	$512.86	$660.69
DeanCare Facility/Professional Professional Modifier 55 Low / Median / High Price $102.33 / $128.82 / $162.18	Professional	55	$102.33	$128.82	$162.18
Medica Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $524.81 / $3,981.07	Facility		$275.42	$524.81	$3,981.07
Medica Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $630.96 / $2,818.38	Professional		$323.59	$630.96	$2,818.38
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $1,380.38 / $1,380.38 / $1,862.09	Professional	50	$1,380.38	$1,380.38	$1,862.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $407.38	Professional		$32.36	$33.11	$407.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $645.65 / $977.24	Professional		$331.13	$645.65	$977.24
Quartz Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $2,951.21 / $2,951.21	Facility		$691.83	$2,951.21	$2,951.21
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $489.78 / $1,318.26 / $1,318.26	Facility	54	$489.78	$1,318.26	$1,318.26
Quartz Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $1,071.52 / $2,818.38	Professional		$309.03	$1,071.52	$2,818.38
Security Health Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $575.44 / $575.44	Facility		$575.44	$575.44	$575.44
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $2,290.87 / $2,951.21	Professional		$1,230.27	$2,290.87	$2,951.21
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 $269.15 / $457.09 / $1,202.26	Professional		$269.15	$457.09	$1,202.26