Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $144.54 / $537.03	Facility		$74.13	$144.54	$537.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $102.33 / $501.19	Professional		$45.71	$102.33	$501.19
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $147.91 / $323.59 / $758.58	Professional	50	$147.91	$323.59	$758.58
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 $63.10 / $95.50 / $223.87	Professional		$63.10	$95.50	$223.87
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $102.33 / $144.54 / $338.84	Professional	50	$102.33	$144.54	$338.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $173.78	Professional		$173.78	$173.78	$173.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $251.19 / $398.11	Facility		$213.80	$251.19	$398.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $158.49 / $269.15	Professional		$77.62	$158.49	$269.15
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $158.49 / $3,715.35	Facility		$47.86	$158.49	$3,715.35
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $144.54 / $239.88	Professional		$100.00	$144.54	$239.88
DeanCare Facility/Professional Professional Modifier 50 Low / Median / High Price $151.36 / $213.80 / $354.81	Professional	50	$151.36	$213.80	$354.81
Medica Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $165.96 / $1,778.28	Facility		$47.86	$165.96	$1,778.28
Medica Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $177.83 / $645.65	Professional		$85.11	$177.83	$645.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $169.82	Professional		$32.36	$33.11	$169.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $144.54 / $275.42	Professional		$81.28	$144.54	$275.42
Quartz Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $1,548.82 / $1,548.82	Facility		$123.03	$1,548.82	$1,548.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $177.83 / $660.69	Professional		$64.57	$177.83	$660.69
Security Health Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $263.03 / $457.09	Professional		$131.83	$263.03	$457.09
United Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $1,548.82 / $1,949.84	Facility		$977.24	$1,548.82	$1,949.84
United Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $120.23 / $295.12	Professional		$53.70	$120.23	$295.12