Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $189.85 / $409.23 / $1,895.46	Facility		$189.85	$409.23	$1,895.46
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $142.38 / $143.63 / $553.50	Facility	54	$142.38	$143.63	$553.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $153.71 / $195.18 / $782.17	Professional		$153.71	$195.18	$782.17
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 $177.92 / $441.98 / $1,156.69	Professional		$177.92	$441.98	$1,156.69
CareSource Facility/Professional Facility Modifier Low / Median / High Price $315.69 / $315.69 / $315.69	Facility		$315.69	$315.69	$315.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $520.85 / $608.65 / $933.69	Facility		$520.85	$608.65	$933.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $241.81 / $589.65 / $998.28	Professional		$241.81	$589.65	$998.28
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $163.25 / $224.08 / $423.26	Facility		$163.25	$224.08	$423.26
Medica Facility/Professional Facility Modifier Low / Median / High Price $174.17 / $284.77 / $1,449.00	Facility		$174.17	$284.77	$1,449.00
Medica Facility/Professional Facility Modifier 54 Low / Median / High Price $369.00 / $369.00 / $369.00	Facility	54	$369.00	$369.00	$369.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $192.00 / $408.13 / $1,452.64	Professional		$192.00	$408.13	$1,452.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.95 / $123.56 / $419.70	Professional		$28.95	$123.56	$419.70
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $163.25 / $224.08 / $423.26	Facility		$163.25	$224.08	$423.26
Quartz Facility/Professional Professional Modifier Low / Median / High Price $396.50 / $488.12 / $721.20	Professional		$396.50	$488.12	$721.20
Quartz Facility/Professional Facility Modifier Low / Median / High Price $257.20 / $257.20 / $3,930.50	Facility		$257.20	$257.20	$3,930.50
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $638.98 / $638.98 / $638.98	Facility	54	$638.98	$638.98	$638.98
Quartz Facility/Professional Professional Modifier Low / Median / High Price $361.65 / $889.10 / $1,469.84	Professional		$361.65	$889.10	$1,469.84
Security Health Facility/Professional Professional Modifier Low / Median / High Price $592.72 / $1,253.04 / $1,268.26	Professional		$592.72	$1,253.04	$1,268.26
United Facility/Professional Facility Modifier Low / Median / High Price $1,008.00 / $1,370.00 / $2,202.90	Facility		$1,008.00	$1,370.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $95.00 / $389.92 / $1,047.23	Professional		$95.00	$389.92	$1,047.23