Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.36 / $374.38 / $1,935.45	Facility		$123.36	$374.38	$1,935.45
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $67.13 / $167.67 / $354.67	Facility	54	$67.13	$167.67	$354.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.97 / $181.57 / $539.41	Professional		$91.97	$181.57	$539.41
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,139.00 / $2,479.00 / $4,441.52	Facility		$1,139.00	$2,479.00	$4,441.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $115.26 / $255.29 / $525.07	Professional		$115.26	$255.29	$525.07
CareSource Facility/Professional Facility Modifier Low / Median / High Price $97.87 / $99.36 / $134.33	Facility		$97.87	$99.36	$134.33
CareSource Facility/Professional Professional Modifier Low / Median / High Price $117.93 / $129.72 / $158.19	Professional		$117.93	$129.72	$158.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $342.43 / $400.15 / $613.84	Facility		$342.43	$400.15	$613.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.62 / $217.54 / $351.60	Professional		$112.62	$217.54	$351.60
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $99.36 / $159.80 / $347.28	Facility		$99.36	$159.80	$347.28
Medica Facility/Professional Facility Modifier Low / Median / High Price $107.27 / $259.17 / $1,455.00	Facility		$107.27	$259.17	$1,455.00
Medica Facility/Professional Facility Modifier 54 Low / Median / High Price $343.32 / $343.32 / $343.32	Facility	54	$343.32	$343.32	$343.32
Medica Facility/Professional Professional Modifier Low / Median / High Price $107.66 / $227.70 / $800.80	Professional		$107.66	$227.70	$800.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.91 / $95.42 / $221.50	Professional		$58.91	$95.42	$221.50
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $99.36 / $159.80 / $347.28	Facility		$99.36	$159.80	$347.28
Quartz Facility/Professional Professional Modifier Low / Median / High Price $223.18 / $302.89 / $422.40	Professional		$223.18	$302.89	$422.40
Quartz Facility/Professional Facility Modifier Low / Median / High Price $209.65 / $280.20 / $490.46	Facility		$209.65	$280.20	$490.46
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $146.76 / $196.14 / $343.32	Facility	54	$146.76	$196.14	$343.32
Quartz Facility/Professional Professional Modifier Low / Median / High Price $169.31 / $488.00 / $950.56	Professional		$169.31	$488.00	$950.56
Security Health Facility/Professional Professional Modifier Low / Median / High Price $186.30 / $410.07 / $551.05	Professional		$186.30	$410.07	$551.05
United Facility/Professional Facility Modifier Low / Median / High Price $1,034.00 / $1,590.00 / $2,202.90	Facility		$1,034.00	$1,590.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $108.20 / $212.96 / $458.46	Professional		$108.20	$212.96	$458.46