Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $245.08 / $528.84 / $1,894.00	Facility		$245.08	$528.84	$1,894.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $183.81 / $200.63 / $770.19	Facility	54	$183.81	$200.63	$770.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $220.46 / $267.51 / $1,026.92	Professional		$220.46	$267.51	$1,026.92
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 $251.97 / $490.15 / $1,417.88	Professional		$251.97	$490.15	$1,417.88
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 $737.12 / $861.38 / $1,321.38	Facility		$737.12	$861.38	$1,321.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $321.02 / $753.16 / $1,262.68	Professional		$321.02	$753.16	$1,262.68
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $245.08 / $343.01 / $587.60	Facility		$245.08	$343.01	$587.60
Medica Facility/Professional Facility Modifier Low / Median / High Price $249.03 / $385.94 / $1,449.00	Facility		$249.03	$385.94	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $272.39 / $578.28 / $2,044.16	Professional		$272.39	$578.28	$2,044.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.53 / $207.91 / $560.33	Professional		$31.53	$207.91	$560.33
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $245.08 / $333.10 / $587.60	Facility		$245.08	$333.10	$587.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $549.13 / $670.03 / $960.72	Professional		$549.13	$670.03	$960.72
Quartz Facility/Professional Facility Modifier Low / Median / High Price $264.92 / $264.92 / $1,193.48	Facility		$264.92	$264.92	$1,193.48
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $824.44 / $824.44 / $824.44	Facility	54	$824.44	$824.44	$824.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $504.26 / $1,169.69 / $2,044.16	Professional		$504.26	$1,169.69	$2,044.16
Security Health Facility/Professional Professional Modifier Low / Median / High Price $763.82 / $1,618.76 / $1,768.28	Professional		$763.82	$1,618.76	$1,768.28
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 $271.39 / $502.92 / $1,146.36	Professional		$271.39	$502.92	$1,146.36