Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $302.00 / $1,905.46	Facility		$177.83	$302.00	$1,905.46
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $891.25 / $891.25 / $1,023.29	Facility	50	$891.25	$891.25	$1,023.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $177.83 / $389.05	Professional		$114.82	$177.83	$389.05
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $173.78 / $457.09 / $1,258.93	Professional	50	$173.78	$457.09	$1,258.93
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 $144.54 / $229.09 / $575.44	Professional		$144.54	$229.09	$575.44
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $218.78 / $346.74 / $851.14	Professional	50	$218.78	$346.74	$851.14
CareSource Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $147.91 / $147.91	Facility		$147.91	$147.91	$147.91
CareSource Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $177.83 / $177.83	Professional		$177.83	$177.83	$177.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $457.09 / $741.31	Facility		$398.11	$457.09	$741.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $323.59 / $537.03	Professional		$134.90	$323.59	$537.03
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $223.87 / $3,548.13	Facility		$128.82	$223.87	$3,548.13
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $316.23 / $398.11	Professional		$257.04	$316.23	$398.11
DeanCare Facility/Professional Professional Modifier 50 Low / Median / High Price $380.19 / $478.63 / $602.56	Professional	50	$380.19	$478.63	$602.56
Medica Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $229.09 / $1,778.28	Facility		$128.82	$229.09	$1,778.28
Medica Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $331.13 / $1,148.15	Professional		$151.36	$331.13	$1,148.15
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $229.09 / $691.83 / $724.44	Professional	50	$229.09	$691.83	$724.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $194.98	Professional		$32.36	$33.11	$194.98
Quartz Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $316.23 / $467.74	Professional		$162.18	$316.23	$467.74
Quartz Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $1,288.25 / $1,288.25	Facility		$346.74	$1,288.25	$1,288.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $537.03 / $1,148.15	Professional		$154.88	$537.03	$1,148.15
Security Health Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $288.40 / $288.40	Facility		$288.40	$288.40	$288.40
Security Health Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $1,148.15 / $1,445.44	Professional		$512.86	$1,148.15	$1,445.44
United Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $1,548.82 / $1,949.84	Facility		$1,023.29	$1,548.82	$1,949.84
United Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $218.78 / $602.56	Professional		$123.03	$218.78	$602.56