Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $448.77 / $950.22 / $1,900.78	Facility		$448.77	$950.22	$1,900.78
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $336.58 / $376.76 / $1,425.59	Facility	54	$336.58	$376.76	$1,425.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $448.77 / $502.34 / $2,052.25	Professional		$448.77	$502.34	$2,052.25
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,183.00 / $3,483.00 / $5,962.00	Facility		$1,183.00	$3,483.00	$5,962.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $478.31 / $1,035.63 / $2,618.55	Professional		$478.31	$1,035.63	$2,618.55
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,942.50 / $1,942.50 / $1,942.50	Facility		$1,942.50	$1,942.50	$1,942.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,364.30 / $1,594.29 / $2,445.67	Facility		$1,364.30	$1,594.29	$2,445.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $638.84 / $1,511.28 / $2,352.66	Professional		$638.84	$1,511.28	$2,352.66
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $448.77 / $606.73 / $1,066.52	Facility		$448.77	$606.73	$1,066.52
Medica Facility/Professional Facility Modifier Low / Median / High Price $462.68 / $711.02 / $1,704.69	Facility		$462.68	$711.02	$1,704.69
Medica Facility/Professional Professional Modifier Low / Median / High Price $539.36 / $1,095.48 / $3,835.28	Professional		$539.36	$1,095.48	$3,835.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $61.84 / $295.74 / $947.18	Professional		$61.84	$295.74	$947.18
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $448.77 / $601.54 / $1,066.52	Facility		$448.77	$601.54	$1,066.52
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,025.08 / $1,250.57 / $1,793.11	Professional		$1,025.08	$1,250.57	$1,793.11
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,722.47 / $1,722.47 / $2,180.00	Facility		$1,722.47	$1,722.47	$2,180.00
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $1,496.25 / $1,496.25 / $1,496.25	Facility	54	$1,496.25	$1,496.25	$1,496.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $933.75 / $2,179.40 / $3,835.28	Professional		$933.75	$2,179.40	$3,835.28
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,416.04 / $2,932.87 / $3,294.78	Professional		$1,416.04	$2,932.87	$3,294.78
United Facility/Professional Facility Modifier Low / Median / High Price $1,008.00 / $1,370.00 / $2,202.90	Facility		$1,008.00	$1,370.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $517.52 / $954.58 / $2,171.67	Professional		$517.52	$954.58	$2,171.67