Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $359.40 / $1,071.22 / $5,109.51	Facility		$359.40	$1,071.22	$5,109.51
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $379.73 / $803.42 / $1,521.26	Facility	54	$379.73	$803.42	$1,521.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $506.30 / $649.12 / $2,520.00	Professional		$506.30	$649.12	$2,520.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,183.00 / $3,483.00 / $5,962.00	Facility		$1,183.00	$3,483.00	$5,962.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $518.79 / $1,019.95 / $2,953.91	Professional		$518.79	$1,019.95	$2,953.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,942.50 / $1,942.50 / $1,942.50	Facility		$1,942.50	$1,942.50	$1,942.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,450.80 / $1,695.38 / $2,600.75	Facility		$1,450.80	$1,695.38	$2,600.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $685.56 / $1,545.39 / $2,509.03	Professional		$685.56	$1,545.39	$2,509.03
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $503.45 / $647.45 / $1,190.25	Facility		$503.45	$647.45	$1,190.25
Medica Facility/Professional Facility Modifier Low / Median / High Price $502.13 / $805.65 / $3,026.00	Facility		$502.13	$805.65	$3,026.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $611.22 / $1,192.29 / $4,098.39	Professional		$611.22	$1,192.29	$4,098.39
Molina Facility/Professional Professional Modifier Low / Median / High Price $61.84 / $310.76 / $1,015.11	Professional		$61.84	$310.76	$1,015.11
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $503.45 / $646.19 / $1,190.25	Facility		$503.45	$646.19	$1,190.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,097.84 / $1,344.65 / $1,980.44	Professional		$1,097.84	$1,344.65	$1,980.44
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,722.47 / $1,722.47 / $2,458.40	Facility		$1,722.47	$1,722.47	$2,458.40
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $1,688.06 / $1,688.06 / $1,688.06	Facility	54	$1,688.06	$1,688.06	$1,688.06
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,002.01 / $2,439.65 / $4,098.39	Professional		$1,002.01	$2,439.65	$4,098.39
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,596.36 / $3,307.92 / $3,513.81	Professional		$1,596.36	$3,307.92	$3,513.81
United Facility/Professional Facility Modifier Low / Median / High Price $2,367.00 / $3,088.30 / $4,295.00	Facility		$2,367.00	$3,088.30	$4,295.00
United Facility/Professional Professional Modifier Low / Median / High Price $580.70 / $1,046.79 / $2,352.53	Professional		$580.70	$1,046.79	$2,352.53