Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $831.76 / $1,000.00	Facility		$602.56	$831.76	$1,000.00
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $645.65 / $812.83 / $977.24	Facility	25	$645.65	$812.83	$977.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $69.18 / $229.09	Professional		$51.29	$69.18	$229.09
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $64.57 / $131.83 / $398.11	Professional	25	$64.57	$131.83	$398.11
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $1,445.44 / $1,445.44	Facility		$1,202.26	$1,445.44	$1,445.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $154.88 / $234.42	Professional		$67.61	$154.88	$234.42
CareSource Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $87.10 / $208.93	Facility		$66.07	$87.10	$208.93
CareSource Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $87.10 / $95.50	Professional		$70.79	$87.10	$95.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $208.93 / $338.84	Facility		$158.49	$208.93	$338.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $151.36 / $239.88	Professional		$72.44	$151.36	$239.88
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $81.28 / $162.18	Facility		$60.26	$81.28	$162.18
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $158.49 / $194.98	Professional		$125.89	$158.49	$194.98
Medica Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $89.13 / $181.97	Facility		$58.88	$89.13	$181.97
Medica Facility/Professional Facility Modifier 25 Low / Median / High Price $891.25 / $891.25 / $891.25	Facility	25	$891.25	$891.25	$891.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $141.25 / $501.19	Professional		$69.18	$141.25	$501.19
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $120.23 / $234.42 / $398.11	Professional	25	$120.23	$234.42	$398.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $81.28	Professional		$32.36	$33.11	$81.28
Quartz Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $165.96 / $245.47	Professional		$107.15	$165.96	$245.47
Quartz Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $131.83 / $131.83	Facility		$131.83	$131.83	$131.83
Quartz Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $316.23 / $501.19	Professional		$72.44	$316.23	$501.19
Security Health Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $234.42 / $295.12	Professional		$114.82	$234.42	$295.12
United Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $102.33 / $177.83	Professional		$64.57	$102.33	$177.83