Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $467.74 / $776.25	Facility		$169.82	$467.74	$776.25
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $776.25 / $776.25 / $776.25	Facility	50	$776.25	$776.25	$776.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $125.89 / $489.78	Professional		$87.10	$125.89	$489.78
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $158.49 / $288.40 / $741.31	Professional	50	$158.49	$288.40	$741.31
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 $100.00 / $177.83 / $512.86	Professional		$100.00	$177.83	$512.86
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $147.91 / $263.03 / $758.58	Professional	50	$147.91	$263.03	$758.58
CareSource Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $117.49 / $117.49	Facility		$117.49	$117.49	$117.49
CareSource Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $141.25 / $141.25	Professional		$141.25	$141.25	$141.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $354.81 / $562.34	Facility		$302.00	$354.81	$562.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $245.47 / $562.34	Professional		$112.20	$245.47	$562.34
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $204.17 / $3,548.13	Facility		$107.15	$204.17	$3,548.13
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $245.47 / $323.59	Professional		$199.53	$245.47	$323.59
DeanCare Facility/Professional Professional Modifier 50 Low / Median / High Price $295.12 / $371.54 / $489.78	Professional	50	$295.12	$371.54	$489.78
Medica Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $245.47 / $1,778.28	Facility		$102.33	$245.47	$1,778.28
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $380.19 / $380.19 / $380.19	Facility	50	$380.19	$380.19	$380.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $346.74 / $3,162.28	Professional		$123.03	$346.74	$3,162.28
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $295.12 / $407.38 / $1,230.27	Professional	50	$295.12	$407.38	$1,230.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $151.36	Professional		$32.36	$33.11	$151.36
Quartz Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $245.47 / $398.11	Professional		$125.89	$245.47	$398.11
Quartz Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $1,288.25 / $1,288.25	Facility		$239.88	$1,288.25	$1,288.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $407.38 / $3,235.94	Professional		$107.15	$407.38	$3,235.94
Security Health Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Facility		$190.55	$190.55	$190.55
Security Health Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $891.25 / $1,096.48	Professional		$457.09	$891.25	$1,096.48
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 $102.33 / $186.21 / $436.52	Professional		$102.33	$186.21	$436.52