Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $304.83 / $395.59 / $3,119.00	Facility		$304.83	$395.59	$3,119.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $228.62 / $258.00 / $980.15	Facility	54	$228.62	$258.00	$980.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $288.18 / $352.02 / $1,557.56	Professional		$288.18	$352.02	$1,557.56
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 $325.81 / $703.45 / $1,858.72	Professional		$325.81	$703.45	$1,858.72
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 $936.26 / $1,094.09 / $1,678.37	Facility		$936.26	$1,094.09	$1,678.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $411.35 / $1,041.54 / $1,776.69	Professional		$411.35	$1,041.54	$1,776.69
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $289.38 / $391.08 / $733.28	Facility		$289.38	$391.08	$733.28
Medica Facility/Professional Facility Modifier Low / Median / High Price $289.38 / $488.85 / $1,449.00	Facility		$289.38	$488.85	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $364.86 / $747.89 / $2,621.60	Professional		$364.86	$747.89	$2,621.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.65 / $205.27 / $696.82	Professional		$38.65	$205.27	$696.82
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $289.38 / $391.08 / $733.28	Facility		$289.38	$391.08	$733.28
Quartz Facility/Professional Professional Modifier Low / Median / High Price $690.94 / $856.15 / $1,278.07	Professional		$690.94	$856.15	$1,278.07
Quartz Facility/Professional Facility Modifier Low / Median / High Price $264.92 / $264.92 / $1,483.12	Facility		$264.92	$264.92	$1,483.12
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $1,020.47 / $1,020.47 / $1,020.47	Facility	54	$1,020.47	$1,020.47	$1,020.47
Quartz Facility/Professional Professional Modifier Low / Median / High Price $630.87 / $1,493.01 / $2,621.60	Professional		$630.87	$1,493.01	$2,621.60
Security Health Facility/Professional Professional Modifier Low / Median / High Price $970.29 / $2,001.42 / $2,257.17	Professional		$970.29	$2,001.42	$2,257.17
United Facility/Professional Facility Modifier Low / Median / High Price $790.92 / $1,297.00 / $2,202.90	Facility		$790.92	$1,297.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $354.61 / $695.51 / $1,454.99	Professional		$354.61	$695.51	$1,454.99