Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $460.00 / $975.76 / $14,482.00	Facility		$460.00	$975.76	$14,482.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $345.00 / $345.00 / $1,304.27	Facility	54	$345.00	$345.00	$1,304.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $438.87 / $480.15 / $2,118.83	Professional		$438.87	$480.15	$2,118.83
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,183.00 / $3,483.00 / $5,962.00	Facility		$1,183.00	$3,483.00	$5,962.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $441.96 / $1,061.55 / $2,690.96	Professional		$441.96	$1,061.55	$2,690.96
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,942.50 / $1,942.50 / $1,942.50	Facility		$1,942.50	$1,942.50	$1,942.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,239.04 / $1,447.92 / $2,221.14	Facility		$1,239.04	$1,447.92	$2,221.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $670.39 / $1,888.79 / $2,146.35	Professional		$670.39	$1,888.79	$2,146.35
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $456.40 / $586.90 / $1,084.18	Facility		$456.40	$586.90	$1,084.18
Medica Facility/Professional Facility Modifier Low / Median / High Price $456.40 / $920.01 / $1,789.00	Facility		$456.40	$920.01	$1,789.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $489.37 / $890.97 / $3,514.08	Professional		$489.37	$890.97	$3,514.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $61.84 / $289.92 / $937.90	Professional		$61.84	$289.92	$937.90
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $456.40 / $586.90 / $1,084.18	Facility		$456.40	$586.90	$1,084.18
Quartz Facility/Professional Professional Modifier Low / Median / High Price $943.15 / $1,149.19 / $1,715.52	Professional		$943.15	$1,149.19	$1,715.52
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,722.47 / $1,722.47 / $4,754.80	Facility		$1,722.47	$1,722.47	$4,754.80
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $3,154.80 / $3,154.80 / $3,154.80	Facility	54	$3,154.80	$3,154.80	$3,154.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $883.69 / $2,216.35 / $3,514.08	Professional		$883.69	$2,216.35	$3,514.08
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,332.62 / $2,311.00 / $3,005.90	Professional		$1,332.62	$2,311.00	$3,005.90
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 $487.60 / $958.02 / $2,126.94	Professional		$487.60	$958.02	$2,126.94