Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $308.07 / $656.33 / $1,261.55	Facility		$308.07	$656.33	$1,261.55
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $231.05 / $249.89 / $946.16	Facility	54	$231.05	$249.89	$946.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $271.11 / $333.18 / $1,387.78	Professional		$271.11	$333.18	$1,387.78
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 $310.88 / $710.94 / $1,785.91	Professional		$310.88	$710.94	$1,785.91
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 $906.53 / $1,059.34 / $1,625.07	Facility		$906.53	$1,059.34	$1,625.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $388.16 / $1,087.83 / $1,558.80	Professional		$388.16	$1,087.83	$1,558.80
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $308.07 / $437.55 / $736.33	Facility		$308.07	$437.55	$736.33
Medica Facility/Professional Facility Modifier Low / Median / High Price $314.60 / $499.77 / $1,449.00	Facility		$314.60	$499.77	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $338.90 / $717.48 / $2,532.56	Professional		$338.90	$717.48	$2,532.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.65 / $202.77 / $681.31	Professional		$38.65	$202.77	$681.31
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $308.07 / $436.18 / $736.33	Facility		$308.07	$436.18	$736.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $677.95 / $826.06 / $1,184.43	Professional		$677.95	$826.06	$1,184.43
Quartz Facility/Professional Facility Modifier Low / Median / High Price $264.92 / $264.92 / $1,492.40	Facility		$264.92	$264.92	$1,492.40
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $1,026.83 / $1,026.83 / $1,026.83	Facility	54	$1,026.83	$1,026.83	$1,026.83
Quartz Facility/Professional Professional Modifier Low / Median / High Price $622.52 / $1,451.65 / $2,532.56	Professional		$622.52	$1,451.65	$2,532.56
Security Health Facility/Professional Professional Modifier Low / Median / High Price $964.89 / $2,018.30 / $2,183.04	Professional		$964.89	$2,018.30	$2,183.04
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 $337.44 / $613.24 / $1,431.71	Professional		$337.44	$613.24	$1,431.71