Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $190.67 / $410.94 / $1,894.00	Facility		$190.67	$410.94	$1,894.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $143.00 / $152.54 / $585.59	Facility	54	$143.00	$152.54	$585.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.97 / $218.41 / $987.83	Professional		$171.97	$218.41	$987.83
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $141.16 / $154.56 / $651.23	Professional	54	$141.16	$154.56	$651.23
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 $190.62 / $440.01 / $1,154.08	Professional		$190.62	$440.01	$1,154.08
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 $560.50 / $654.98 / $1,004.76	Facility		$560.50	$654.98	$1,004.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $236.90 / $706.21 / $1,057.66	Professional		$236.90	$706.21	$1,057.66
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $182.64 / $235.39 / $449.49	Facility		$182.64	$235.39	$449.49
Medica Facility/Professional Facility Modifier Low / Median / High Price $182.64 / $292.07 / $1,449.00	Facility		$182.64	$292.07	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $208.84 / $435.74 / $1,554.96	Professional		$208.84	$435.74	$1,554.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.95 / $123.56 / $416.25	Professional		$28.95	$123.56	$416.25
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $182.64 / $233.78 / $449.49	Facility		$182.64	$233.78	$449.49
Quartz Facility/Professional Professional Modifier Low / Median / High Price $418.60 / $510.68 / $761.40	Professional		$418.60	$510.68	$761.40
Quartz Facility/Professional Facility Modifier Low / Median / High Price $264.92 / $264.92 / $930.88	Facility		$264.92	$264.92	$930.88
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $641.12 / $641.12 / $641.12	Facility	54	$641.12	$641.12	$641.12
Quartz Facility/Professional Professional Modifier Low / Median / High Price $383.17 / $891.00 / $1,554.96	Professional		$383.17	$891.00	$1,554.96
Security Health Facility/Professional Professional Modifier Low / Median / High Price $594.21 / $1,261.33 / $1,343.71	Professional		$594.21	$1,261.33	$1,343.71
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 $208.84 / $409.32 / $847.72	Professional		$208.84	$409.32	$847.72