Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $299.36 / $637.55 / $3,119.00	Facility		$299.36	$637.55	$3,119.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $224.52 / $249.88 / $947.15	Facility	54	$224.52	$249.88	$947.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $273.06 / $338.35 / $1,408.00	Professional		$273.06	$338.35	$1,408.00
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 $311.73 / $598.70 / $1,825.43	Professional		$311.73	$598.70	$1,825.43
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 $910.13 / $1,063.56 / $1,631.53	Facility		$910.13	$1,063.56	$1,631.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $405.51 / $1,090.98 / $1,721.31	Professional		$405.51	$1,090.98	$1,721.31
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $283.36 / $377.92 / $708.59	Facility		$283.36	$377.92	$708.59
Medica Facility/Professional Facility Modifier Low / Median / High Price $283.36 / $457.04 / $1,449.00	Facility		$283.36	$457.04	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $340.28 / $717.14 / $2,533.04	Professional		$340.28	$717.14	$2,533.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.53 / $147.84 / $691.33	Professional		$31.53	$147.84	$691.33
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $283.36 / $377.92 / $708.59	Facility		$283.36	$377.92	$708.59
Quartz Facility/Professional Professional Modifier Low / Median / High Price $677.36 / $826.06 / $1,233.14	Professional		$677.36	$826.06	$1,233.14
Quartz Facility/Professional Facility Modifier Low / Median / High Price $264.92 / $264.92 / $1,450.88	Facility		$264.92	$264.92	$1,450.88
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $997.15 / $997.15 / $997.15	Facility	54	$997.15	$997.15	$997.15
Quartz Facility/Professional Professional Modifier Low / Median / High Price $616.77 / $1,446.48 / $2,533.04	Professional		$616.77	$1,446.48	$2,533.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $941.38 / $1,963.52 / $2,186.77	Professional		$941.38	$1,963.52	$2,186.77
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 $335.64 / $616.98 / $1,421.65	Professional		$335.64	$616.98	$1,421.65