Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $259.43 / $557.89 / $1,894.00	Facility		$259.43	$557.89	$1,894.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $194.57 / $215.67 / $824.84	Facility	54	$194.57	$215.67	$824.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $226.50 / $287.56 / $1,165.59	Professional		$226.50	$287.56	$1,165.59
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 $262.27 / $518.86 / $1,502.86	Professional		$262.27	$518.86	$1,502.86
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 $789.38 / $922.45 / $1,415.07	Facility		$789.38	$922.45	$1,415.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $334.66 / $955.95 / $1,354.00	Professional		$334.66	$955.95	$1,354.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $259.43 / $336.45 / $619.88	Facility		$259.43	$336.45	$619.88
Medica Facility/Professional Facility Modifier Low / Median / High Price $262.42 / $389.15 / $1,449.00	Facility		$262.42	$389.15	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $288.00 / $613.35 / $2,195.76	Professional		$288.00	$613.35	$2,195.76
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 $259.43 / $336.45 / $619.88	Facility		$259.43	$336.45	$619.88
Quartz Facility/Professional Professional Modifier Low / Median / High Price $583.83 / $718.34 / $1,029.99	Professional		$583.83	$718.34	$1,029.99
Quartz Facility/Professional Facility Modifier Low / Median / High Price $264.92 / $264.92 / $1,264.28	Facility		$264.92	$264.92	$1,264.28
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $871.06 / $871.06 / $871.06	Facility	54	$871.06	$871.06	$871.06
Quartz Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $1,254.29 / $2,195.76	Professional		$537.03	$1,254.29	$2,195.76
Security Health Facility/Professional Professional Modifier Low / Median / High Price $808.80 / $1,712.06 / $1,896.23	Professional		$808.80	$1,712.06	$1,896.23
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 $288.00 / $525.62 / $1,215.90	Professional		$288.00	$525.62	$1,215.90