Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $180.45 / $570.14 / $5,927.04	Facility		$180.45	$570.14	$5,927.04
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $116.00 / $285.95 / $591.54	Facility	54	$116.00	$285.95	$591.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $154.66 / $226.50 / $901.00	Professional		$154.66	$226.50	$901.00
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 $199.65 / $442.90 / $902.42	Professional		$199.65	$442.90	$902.42
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $299.47 / $691.48 / $1,399.00	Professional	50	$299.47	$691.48	$1,399.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $167.76 / $169.45 / $232.31	Facility		$167.76	$169.45	$232.31
CareSource Facility/Professional Professional Modifier Low / Median / High Price $196.69 / $216.36 / $267.31	Professional		$196.69	$216.36	$267.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $571.30 / $667.62 / $1,024.15	Facility		$571.30	$667.62	$1,024.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $192.71 / $349.22 / $584.73	Professional		$192.71	$349.22	$584.73
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $169.45 / $266.99 / $586.67	Facility		$169.45	$266.99	$586.67
Medica Facility/Professional Facility Modifier Low / Median / High Price $180.95 / $467.35 / $1,642.00	Facility		$180.95	$467.35	$1,642.00
Medica Facility/Professional Facility Modifier 54 Low / Median / High Price $589.19 / $589.19 / $589.19	Facility	54	$589.19	$589.19	$589.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $190.27 / $399.10 / $1,378.80	Professional		$190.27	$399.10	$1,378.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $102.76 / $186.96 / $419.70	Professional		$102.76	$186.96	$419.70
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $169.45 / $266.99 / $586.67	Facility		$169.45	$266.99	$586.67
Quartz Facility/Professional Professional Modifier Low / Median / High Price $375.71 / $510.05 / $708.40	Professional		$375.71	$510.05	$708.40
Quartz Facility/Professional Facility Modifier Low / Median / High Price $357.54 / $477.85 / $841.70	Facility		$357.54	$477.85	$841.70
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $250.28 / $334.50 / $589.19	Facility	54	$250.28	$334.50	$589.19
Quartz Facility/Professional Professional Modifier Low / Median / High Price $243.62 / $878.55 / $1,602.24	Professional		$243.62	$878.55	$1,602.24
Security Health Facility/Professional Professional Modifier Low / Median / High Price $327.50 / $720.22 / $923.93	Professional		$327.50	$720.22	$923.93
United Facility/Professional Facility Modifier Low / Median / High Price $1,034.00 / $1,423.00 / $2,202.90	Facility		$1,034.00	$1,423.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $190.27 / $325.16 / $792.65	Professional		$190.27	$325.16	$792.65