Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $260.87 / $571.09 / $2,373.12	Facility		$260.87	$571.09	$2,373.12
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $195.65 / $420.14 / $840.02	Facility	54	$195.65	$420.14	$840.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $229.87 / $293.33 / $1,246.00	Professional		$229.87	$293.33	$1,246.00
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 $271.73 / $521.73 / $1,511.32	Professional		$271.73	$521.73	$1,511.32
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 $803.80 / $939.30 / $1,440.91	Facility		$803.80	$939.30	$1,440.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $339.19 / $901.60 / $1,379.26	Professional		$339.19	$901.60	$1,379.26
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $260.87 / $357.52 / $628.45	Facility		$260.87	$357.52	$628.45
Medica Facility/Professional Facility Modifier Low / Median / High Price $267.63 / $399.00 / $1,449.00	Facility		$267.63	$399.00	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $294.13 / $647.03 / $2,236.16	Professional		$294.13	$647.03	$2,236.16
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 $260.87 / $351.44 / $628.45	Facility		$260.87	$351.44	$628.45
Quartz Facility/Professional Professional Modifier Low / Median / High Price $587.60 / $731.81 / $1,049.29	Professional		$587.60	$731.81	$1,049.29
Quartz Facility/Professional Facility Modifier Low / Median / High Price $264.92 / $264.92 / $1,270.16	Facility		$264.92	$264.92	$1,270.16
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $875.28 / $875.28 / $875.28	Facility	54	$875.28	$875.28	$875.28
Quartz Facility/Professional Professional Modifier Low / Median / High Price $539.28 / $1,277.69 / $2,236.16	Professional		$539.28	$1,277.69	$2,236.16
Security Health Facility/Professional Professional Modifier Low / Median / High Price $809.89 / $1,719.18 / $1,931.57	Professional		$809.89	$1,719.18	$1,931.57
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 $294.13 / $575.74 / $1,242.33	Professional		$294.13	$575.74	$1,242.33