Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $247.99 / $533.50 / $1,894.00	Facility		$247.99	$533.50	$1,894.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $185.99 / $200.30 / $766.19	Facility	54	$185.99	$200.30	$766.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $226.64 / $290.62 / $1,227.00	Professional		$226.64	$290.62	$1,227.00
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 $251.73 / $572.29 / $1,435.27	Professional		$251.73	$572.29	$1,435.27
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 $733.51 / $857.17 / $1,314.92	Facility		$733.51	$857.17	$1,314.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $312.81 / $915.32 / $1,256.46	Professional		$312.81	$915.32	$1,256.46
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $237.11 / $312.47 / $590.22	Facility		$237.11	$312.47	$590.22
Medica Facility/Professional Facility Modifier Low / Median / High Price $237.11 / $374.40 / $1,449.00	Facility		$237.11	$374.40	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $274.47 / $577.27 / $2,035.92	Professional		$274.47	$577.27	$2,035.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.95 / $184.63 / $563.93	Professional		$28.95	$184.63	$563.93
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $237.11 / $312.47 / $590.22	Facility		$237.11	$312.47	$590.22
Quartz Facility/Professional Professional Modifier Low / Median / High Price $548.60 / $668.45 / $958.45	Professional		$548.60	$668.45	$958.45
Quartz Facility/Professional Facility Modifier Low / Median / High Price $264.92 / $264.92 / $1,207.11	Facility		$264.92	$264.92	$1,207.11
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $833.97 / $833.97 / $833.97	Facility	54	$833.97	$833.97	$833.97
Quartz Facility/Professional Professional Modifier Low / Median / High Price $501.79 / $1,163.93 / $2,035.92	Professional		$501.79	$1,163.93	$2,035.92
Security Health Facility/Professional Professional Modifier Low / Median / High Price $773.40 / $1,636.12 / $1,759.64	Professional		$773.40	$1,636.12	$1,759.64
United Facility/Professional Facility Modifier Low / Median / High Price $790.92 / $1,297.00 / $2,202.90	Facility		$790.92	$1,297.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $271.02 / $500.90 / $1,144.36	Professional		$271.02	$500.90	$1,144.36