Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $470.60 / $997.09 / $1,894.00	Facility		$470.60	$997.09	$1,894.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $352.95 / $360.23 / $1,356.98	Facility	54	$352.95	$360.23	$1,356.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $448.78 / $492.65 / $2,168.44	Professional		$448.78	$492.65	$2,168.44
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 $458.61 / $1,086.00 / $2,750.00	Professional		$458.61	$1,086.00	$2,750.00
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 $1,294.01 / $1,512.15 / $2,319.67	Facility		$1,294.01	$1,512.15	$2,319.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $610.79 / $1,432.99 / $2,240.69	Professional		$610.79	$1,432.99	$2,240.69
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $449.37 / $597.20 / $1,061.49	Facility		$449.37	$597.20	$1,061.49
Medica Facility/Professional Facility Modifier Low / Median / High Price $449.37 / $684.31 / $1,449.68	Facility		$449.37	$684.31	$1,449.68
Medica Facility/Professional Professional Modifier Low / Median / High Price $514.66 / $1,064.93 / $3,665.28	Professional		$514.66	$1,064.93	$3,665.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $61.84 / $296.71 / $950.10	Professional		$61.84	$296.71	$950.10
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $449.37 / $590.23 / $1,061.49	Facility		$449.37	$590.23	$1,061.49
Quartz Facility/Professional Professional Modifier Low / Median / High Price $980.20 / $1,206.70 / $1,782.91	Professional		$980.20	$1,206.70	$1,782.91
Quartz Facility/Professional Facility Modifier Low / Median / High Price $264.92 / $264.92 / $2,860.45	Facility		$264.92	$264.92	$2,860.45
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $1,570.45 / $1,570.45 / $1,570.45	Facility	54	$1,570.45	$1,570.45	$1,570.45
Quartz Facility/Professional Professional Modifier Low / Median / High Price $894.85 / $2,268.25 / $3,665.28	Professional		$894.85	$2,268.25	$3,665.28
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,485.88 / $3,077.34 / $3,138.00	Professional		$1,485.88	$3,077.34	$3,138.00
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 $501.30 / $921.68 / $2,096.82	Professional		$501.30	$921.68	$2,096.82