Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $204.06 / $640.62 / $1,270.81	Facility		$204.06	$640.62	$1,270.81
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $149.22 / $165.96 / $635.41	Facility	52	$149.22	$165.96	$635.41
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $223.83 / $248.94 / $953.11	Facility	54	$223.83	$248.94	$953.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $254.15 / $331.92 / $1,270.81	Professional		$254.15	$331.92	$1,270.81
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 $307.67 / $688.70 / $1,711.57	Professional		$307.67	$688.70	$1,711.57
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 $906.53 / $1,059.34 / $1,625.07	Facility		$906.53	$1,059.34	$1,625.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $398.23 / $905.77 / $1,563.13	Professional		$398.23	$905.77	$1,563.13
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $284.72 / $380.29 / $713.05	Facility		$284.72	$380.29	$713.05
Medica Facility/Professional Facility Modifier Low / Median / High Price $284.72 / $481.67 / $1,368.00	Facility		$284.72	$481.67	$1,368.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $331.30 / $701.73 / $2,546.80	Professional		$331.30	$701.73	$2,546.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.65 / $188.51 / $696.82	Professional		$38.65	$188.51	$696.82
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $284.72 / $380.29 / $713.05	Facility		$284.72	$380.29	$713.05
Quartz Facility/Professional Professional Modifier Low / Median / High Price $670.57 / $835.56 / $1,198.06	Professional		$670.57	$835.56	$1,198.06
Quartz Facility/Professional Facility Modifier Low / Median / High Price $264.92 / $264.92 / $1,439.66	Facility		$264.92	$264.92	$1,439.66
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $1,151.73 / $1,151.73 / $1,151.73	Facility	52	$1,151.73	$1,151.73	$1,151.73
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $1,007.76 / $1,007.76 / $1,007.76	Facility	54	$1,007.76	$1,007.76	$1,007.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $617.34 / $1,448.01 / $2,546.80	Professional		$617.34	$1,448.01	$2,546.80
Security Health Facility/Professional Professional Modifier Low / Median / High Price $929.67 / $1,968.09 / $2,189.12	Professional		$929.67	$1,968.09	$2,189.12
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 $316.91 / $603.90 / $1,345.10	Professional		$316.91	$603.90	$1,345.10