Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $335.40 / $716.36 / $1,894.00	Facility		$335.40	$716.36	$1,894.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $251.55 / $273.39 / $1,042.25	Facility	54	$251.55	$273.39	$1,042.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $300.43 / $364.52 / $1,276.70	Professional		$300.43	$364.52	$1,276.70
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 $344.01 / $773.99 / $1,948.97	Professional		$344.01	$773.99	$1,948.97
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 $998.44 / $1,166.76 / $1,789.84	Facility		$998.44	$1,166.76	$1,789.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $433.38 / $1,109.92 / $1,714.94	Professional		$433.38	$1,109.92	$1,714.94
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $306.79 / $417.46 / $795.95	Facility		$306.79	$417.46	$795.95
Medica Facility/Professional Facility Modifier Low / Median / High Price $318.38 / $510.73 / $1,449.00	Facility		$318.38	$510.73	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $377.17 / $789.25 / $2,784.64	Professional		$377.17	$789.25	$2,784.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $52.59 / $219.65 / $734.14	Professional		$52.59	$219.65	$734.14
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $306.79 / $415.86 / $795.95	Facility		$306.79	$415.86	$795.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $746.20 / $909.22 / $1,303.67	Professional		$746.20	$909.22	$1,303.67
Quartz Facility/Professional Facility Modifier Low / Median / High Price $264.92 / $264.92 / $1,632.24	Facility		$264.92	$264.92	$1,632.24
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $1,120.06 / $1,120.06 / $1,120.06	Facility	54	$1,120.06	$1,120.06	$1,120.06
Quartz Facility/Professional Professional Modifier Low / Median / High Price $684.87 / $1,588.64 / $2,784.64	Professional		$684.87	$1,588.64	$2,784.64
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,049.03 / $2,206.62 / $2,401.65	Professional		$1,049.03	$2,206.62	$2,401.65
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 $371.34 / $687.44 / $1,564.61	Professional		$371.34	$687.44	$1,564.61