Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $501.19 / $3,715.35	Facility		$218.78	$501.19	$3,715.35
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $2,089.30 / $3,162.28 / $6,025.60	Facility	25	$2,089.30	$3,162.28	$6,025.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $251.19 / $812.83	Professional		$173.78	$251.19	$812.83
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $190.55 / $398.11 / $1,348.96	Professional	25	$190.55	$398.11	$1,348.96
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,754.40 / $7,244.36 / $8,709.64	Facility		$5,754.40	$7,244.36	$8,709.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $380.19 / $676.08	Professional		$251.19	$380.19	$676.08
CareSource Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $275.42 / $380.19	Facility		$199.53	$275.42	$380.19
CareSource Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $354.81 / $549.54	Professional		$269.15	$354.81	$549.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $831.76 / $1,348.96	Facility		$630.96	$831.76	$1,348.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $426.58 / $776.25	Professional		$223.87	$426.58	$776.25
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $251.19 / $501.19	Facility		$181.97	$251.19	$501.19
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $537.03 / $724.44	Professional		$389.05	$537.03	$724.44
Medica Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $257.04 / $524.81	Facility		$181.97	$257.04	$524.81
Medica Facility/Professional Facility Modifier 25 Low / Median / High Price $1,288.25 / $1,288.25 / $1,288.25	Facility	25	$1,288.25	$1,288.25	$1,288.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $575.44 / $1,737.80	Professional		$275.42	$575.44	$1,737.80
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $363.08 / $1,047.13 / $1,380.38	Professional	25	$363.08	$1,047.13	$1,380.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $354.81	Professional		$32.36	$33.11	$354.81
Quartz Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $575.44 / $933.25	Professional		$338.84	$575.44	$933.25
Quartz Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $1,348.96 / $1,348.96	Facility		$398.11	$1,348.96	$1,348.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $645.65 / $1,737.80	Professional		$218.78	$645.65	$1,737.80
Security Health Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $562.34 / $831.76	Professional		$371.54	$562.34	$831.76
United Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $346.74 / $602.56	Professional		$229.09	$346.74	$602.56