Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $238.26 / $506.75 / $1,894.00	Facility		$238.26	$506.75	$1,894.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $178.70 / $180.95 / $682.01	Facility	54	$178.70	$180.95	$682.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $215.33 / $246.60 / $957.19	Professional		$215.33	$246.60	$957.19
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 $220.42 / $541.27 / $1,372.76	Professional		$220.42	$541.27	$1,372.76
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 $656.02 / $766.61 / $1,175.99	Facility		$656.02	$766.61	$1,175.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $302.60 / $725.41 / $1,127.93	Professional		$302.60	$725.41	$1,127.93
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $225.22 / $282.29 / $511.49	Facility		$225.22	$282.29	$511.49
Medica Facility/Professional Facility Modifier Low / Median / High Price $225.22 / $356.08 / $1,449.00	Facility		$225.22	$356.08	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $240.72 / $510.41 / $1,833.36	Professional		$240.72	$510.41	$1,833.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.53 / $182.42 / $484.25	Professional		$31.53	$182.42	$484.25
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $226.77 / $282.29 / $511.49	Facility		$226.77	$282.29	$511.49
Quartz Facility/Professional Professional Modifier Low / Median / High Price $490.10 / $603.35 / $882.18	Professional		$490.10	$603.35	$882.18
Quartz Facility/Professional Facility Modifier Low / Median / High Price $264.92 / $264.92 / $1,447.20	Facility		$264.92	$264.92	$1,447.20
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $793.71 / $793.71 / $793.71	Facility	54	$793.71	$793.71	$793.71
Quartz Facility/Professional Professional Modifier Low / Median / High Price $450.44 / $1,106.75 / $1,833.36	Professional		$450.44	$1,106.75	$1,833.36
Security Health Facility/Professional Professional Modifier Low / Median / High Price $721.94 / $1,566.61 / $1,579.61	Professional		$721.94	$1,566.61	$1,579.61
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 $236.82 / $444.76 / $1,011.83	Professional		$236.82	$444.76	$1,011.83