Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $286.66 / $613.53 / $14,482.00	Facility		$286.66	$613.53	$14,482.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $215.00 / $233.33 / $890.82	Facility	54	$215.00	$233.33	$890.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $256.29 / $311.10 / $1,367.10	Professional		$256.29	$311.10	$1,367.10
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 $294.01 / $573.32 / $1,660.80	Professional		$294.01	$573.32	$1,660.80
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 $852.46 / $996.17 / $1,528.14	Facility		$852.46	$996.17	$1,528.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $364.76 / $1,051.55 / $1,462.19	Professional		$364.76	$1,051.55	$1,462.19
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $286.66 / $376.91 / $681.70	Facility		$286.66	$376.91	$681.70
Medica Facility/Professional Facility Modifier Low / Median / High Price $292.20 / $445.09 / $1,449.00	Facility		$292.20	$445.09	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $321.85 / $660.13 / $2,370.56	Professional		$321.85	$660.13	$2,370.56
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 $286.66 / $376.80 / $681.70	Facility		$286.66	$376.80	$681.70
Quartz Facility/Professional Professional Modifier Low / Median / High Price $636.35 / $775.37 / $1,111.75	Professional		$636.35	$775.37	$1,111.75
Quartz Facility/Professional Facility Modifier Low / Median / High Price $264.92 / $264.92 / $1,391.08	Facility		$264.92	$264.92	$1,391.08
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $956.89 / $956.89 / $956.89	Facility	54	$956.89	$956.89	$956.89
Quartz Facility/Professional Professional Modifier Low / Median / High Price $583.94 / $1,354.50 / $2,370.56	Professional		$583.94	$1,354.50	$2,370.56
Security Health Facility/Professional Professional Modifier Low / Median / High Price $894.84 / $1,885.16 / $2,047.76	Professional		$894.84	$1,885.16	$2,047.76
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 $321.85 / $586.78 / $1,339.37	Professional		$321.85	$586.78	$1,339.37