Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $225.05 / $482.11 / $1,894.00	Facility		$225.05	$482.11	$1,894.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $168.79 / $172.55 / $660.24	Facility	54	$168.79	$172.55	$660.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $197.47 / $235.32 / $1,079.50	Professional		$197.47	$235.32	$1,079.50
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 $210.28 / $529.15 / $1,328.02	Professional		$210.28	$529.15	$1,328.02
CareSource Facility/Professional Facility Modifier Low / Median / High Price $319.44 / $319.44 / $319.44	Facility		$319.44	$319.44	$319.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $614.55 / $718.17 / $1,101.69	Facility		$614.55	$718.17	$1,101.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $275.72 / $702.62 / $1,081.91	Professional		$275.72	$702.62	$1,081.91
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $214.27 / $272.26 / $508.45	Facility		$214.27	$272.26	$508.45
Medica Facility/Professional Facility Modifier Low / Median / High Price $214.27 / $339.72 / $1,449.00	Facility		$214.27	$339.72	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $231.28 / $483.81 / $1,718.32	Professional		$231.28	$483.81	$1,718.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.95 / $153.19 / $429.02	Professional		$28.95	$153.19	$429.02
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $214.27 / $270.00 / $508.45	Facility		$214.27	$270.00	$508.45
Quartz Facility/Professional Professional Modifier Low / Median / High Price $474.50 / $584.15 / $857.87	Professional		$474.50	$584.15	$857.87
Quartz Facility/Professional Facility Modifier Low / Median / High Price $264.92 / $264.92 / $2,088.44	Facility		$264.92	$264.92	$2,088.44
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $755.54 / $755.54 / $755.54	Facility	54	$755.54	$755.54	$755.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $432.08 / $1,053.95 / $1,757.60	Professional		$432.08	$1,053.95	$1,757.60
Security Health Facility/Professional Professional Modifier Low / Median / High Price $703.34 / $1,480.51 / $1,515.23	Professional		$703.34	$1,480.51	$1,515.23
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 $228.09 / $419.50 / $959.09	Professional		$228.09	$419.50	$959.09