Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $315.26 / $674.10 / $1,894.00	Facility		$315.26	$674.10	$1,894.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $236.45 / $266.07 / $1,013.71	Facility	54	$236.45	$266.07	$1,013.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $286.87 / $354.76 / $1,479.00	Professional		$286.87	$354.76	$1,479.00
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 $331.09 / $727.51 / $1,830.93	Professional		$331.09	$727.51	$1,830.93
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 $974.11 / $1,138.33 / $1,746.22	Facility		$974.11	$1,138.33	$1,746.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $413.19 / $958.30 / $1,671.06	Professional		$413.19	$958.30	$1,671.06
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $274.11 / $404.47 / $758.74	Facility		$274.11	$404.47	$758.74
Medica Facility/Professional Facility Modifier Low / Median / High Price $289.58 / $476.31 / $1,449.00	Facility		$289.58	$476.31	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $358.01 / $762.60 / $2,708.08	Professional		$358.01	$762.60	$2,708.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $52.59 / $214.81 / $681.31	Professional		$52.59	$214.81	$681.31
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $274.11 / $404.47 / $758.74	Facility		$274.11	$404.47	$758.74
Quartz Facility/Professional Professional Modifier Low / Median / High Price $711.30 / $883.08 / $1,266.19	Professional		$711.30	$883.08	$1,266.19
Quartz Facility/Professional Facility Modifier Low / Median / High Price $264.92 / $264.92 / $1,535.12	Facility		$264.92	$264.92	$1,535.12
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $1,053.30 / $1,053.30 / $1,053.30	Facility	54	$1,053.30	$1,053.30	$1,053.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $651.83 / $1,548.00 / $2,708.08	Professional		$651.83	$1,548.00	$2,708.08
Security Health Facility/Professional Professional Modifier Low / Median / High Price $982.95 / $2,078.05 / $2,340.23	Professional		$982.95	$2,078.05	$2,340.23
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 $358.01 / $653.66 / $1,511.78	Professional		$358.01	$653.66	$1,511.78