Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $261.80 / $559.82 / $1,894.00	Facility		$261.80	$559.82	$1,894.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $196.35 / $205.14 / $782.73	Facility	54	$196.35	$205.14	$782.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $255.33 / $278.80 / $1,180.90	Professional		$255.33	$278.80	$1,180.90
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 $257.68 / $604.15 / $1,520.76	Professional		$257.68	$604.15	$1,520.76
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 $747.93 / $874.01 / $1,340.76	Facility		$747.93	$874.01	$1,340.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $344.42 / $959.54 / $1,284.05	Professional		$344.42	$959.54	$1,284.05
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $248.81 / $320.02 / $604.48	Facility		$248.81	$320.02	$604.48
Medica Facility/Professional Facility Modifier Low / Median / High Price $248.81 / $392.70 / $1,449.00	Facility		$248.81	$392.70	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $283.44 / $591.40 / $2,084.23	Professional		$283.44	$591.40	$2,084.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.53 / $147.84 / $627.32	Professional		$31.53	$147.84	$627.32
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $248.81 / $318.48 / $604.48	Facility		$248.81	$318.48	$604.48
Quartz Facility/Professional Professional Modifier Low / Median / High Price $560.29 / $689.77 / $997.93	Professional		$560.29	$689.77	$997.93
Quartz Facility/Professional Facility Modifier Low / Median / High Price $264.92 / $264.92 / $1,588.00	Facility		$264.92	$264.92	$1,588.00
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $874.23 / $874.23 / $874.23	Facility	54	$874.23	$874.23	$874.23
Quartz Facility/Professional Professional Modifier Low / Median / High Price $512.79 / $1,235.25 / $2,084.23	Professional		$512.79	$1,235.25	$2,084.23
Security Health Facility/Professional Professional Modifier Low / Median / High Price $823.99 / $1,720.22 / $1,798.23	Professional		$823.99	$1,720.22	$1,798.23
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 $278.25 / $546.83 / $1,172.40	Professional		$278.25	$546.83	$1,172.40