Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $269.41 / $576.29 / $1,894.00	Facility		$269.41	$576.29	$1,894.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $202.06 / $221.39 / $844.81	Facility	54	$202.06	$221.39	$844.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $245.94 / $295.19 / $1,214.88	Professional		$245.94	$295.19	$1,214.88
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 $279.41 / $621.72 / $1,564.13	Professional		$279.41	$621.72	$1,564.13
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 $808.30 / $944.57 / $1,448.99	Facility		$808.30	$944.57	$1,448.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $348.90 / $818.57 / $1,387.18	Professional		$348.90	$818.57	$1,387.18
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $256.13 / $337.08 / $640.33	Facility		$256.13	$337.08	$640.33
Medica Facility/Professional Facility Modifier Low / Median / High Price $256.13 / $410.44 / $1,449.00	Facility		$256.13	$410.44	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $306.95 / $641.53 / $2,250.64	Professional		$306.95	$641.53	$2,250.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.65 / $182.56 / $593.82	Professional		$38.65	$182.56	$593.82
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $256.13 / $337.08 / $640.33	Facility		$256.13	$337.08	$640.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $604.50 / $736.56 / $1,056.10	Professional		$604.50	$736.56	$1,056.10
Quartz Facility/Professional Facility Modifier Low / Median / High Price $264.92 / $264.92 / $1,309.00	Facility		$264.92	$264.92	$1,309.00
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $900.74 / $900.74 / $900.74	Facility	54	$900.74	$900.74	$900.74
Quartz Facility/Professional Professional Modifier Low / Median / High Price $553.99 / $1,285.02 / $2,250.64	Professional		$553.99	$1,285.02	$2,250.64
Security Health Facility/Professional Professional Modifier Low / Median / High Price $844.84 / $1,771.53 / $1,942.70	Professional		$844.84	$1,771.53	$1,942.70
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 $301.70 / $571.00 / $1,271.77	Professional		$301.70	$571.00	$1,271.77