Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $236.36 / $506.05 / $1,894.00	Facility		$236.36	$506.05	$1,894.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $177.27 / $183.05 / $700.63	Facility	54	$177.27	$183.05	$700.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $200.02 / $244.94 / $1,066.23	Professional		$200.02	$244.94	$1,066.23
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 $222.52 / $558.58 / $1,415.26	Professional		$222.52	$558.58	$1,415.26
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 $644.29 / $752.92 / $1,154.99	Facility		$644.29	$752.92	$1,154.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $306.66 / $745.23 / $1,148.04	Professional		$306.66	$745.23	$1,148.04
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $224.91 / $285.55 / $539.37	Facility		$224.91	$285.55	$539.37
Medica Facility/Professional Facility Modifier Low / Median / High Price $223.66 / $354.54 / $1,449.00	Facility		$223.66	$354.54	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $245.98 / $511.97 / $1,803.84	Professional		$245.98	$511.97	$1,803.84
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 $224.91 / $285.55 / $539.37	Facility		$224.91	$285.55	$539.37
Quartz Facility/Professional Professional Modifier Low / Median / High Price $503.10 / $619.35 / $908.50	Professional		$503.10	$619.35	$908.50
Quartz Facility/Professional Facility Modifier Low / Median / High Price $264.92 / $264.92 / $2,000.00	Facility		$264.92	$264.92	$2,000.00
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $792.63 / $792.63 / $792.63	Facility	54	$792.63	$792.63	$792.63
Quartz Facility/Professional Professional Modifier Low / Median / High Price $458.48 / $1,115.30 / $1,865.28	Professional		$458.48	$1,115.30	$1,865.28
Security Health Facility/Professional Professional Modifier Low / Median / High Price $745.40 / $1,553.61 / $1,607.76	Professional		$745.40	$1,553.61	$1,607.76
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 $245.37 / $446.12 / $981.46	Professional		$245.37	$446.12	$981.46