Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $381.06 / $809.06 / $1,894.00	Facility		$381.06	$809.06	$1,894.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $285.80 / $289.06 / $1,090.76	Facility	54	$285.80	$289.06	$1,090.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $367.75 / $402.30 / $1,548.50	Professional		$367.75	$402.30	$1,548.50
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 $370.34 / $879.37 / $2,224.36	Professional		$370.34	$879.37	$2,224.36
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 $1,037.19 / $1,212.04 / $1,859.30	Facility		$1,037.19	$1,212.04	$1,859.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $542.90 / $1,150.55 / $1,796.54	Professional		$542.90	$1,150.55	$1,796.54
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $362.68 / $450.93 / $851.76	Facility		$362.68	$450.93	$851.76
Medica Facility/Professional Facility Modifier Low / Median / High Price $362.67 / $571.59 / $1,449.00	Facility		$362.67	$571.59	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $421.03 / $875.26 / $2,941.28	Professional		$421.03	$875.26	$2,941.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.65 / $232.22 / $767.16	Professional		$38.65	$232.22	$767.16
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $362.68 / $450.93 / $851.76	Facility		$362.68	$450.93	$851.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $789.10 / $971.44 / $1,435.31	Professional		$789.10	$971.44	$1,435.31
Quartz Facility/Professional Facility Modifier Low / Median / High Price $264.92 / $264.92 / $2,314.75	Facility		$264.92	$264.92	$2,314.75
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $1,275.83 / $1,275.83 / $1,275.83	Facility	54	$1,275.83	$1,275.83	$1,275.83
Quartz Facility/Professional Professional Modifier Low / Median / High Price $717.47 / $1,843.45 / $2,941.28	Professional		$717.47	$1,843.45	$2,941.28
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,205.67 / $2,490.04 / $2,516.04	Professional		$1,205.67	$2,490.04	$2,516.04
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 $405.39 / $801.56 / $1,688.46	Professional		$405.39	$801.56	$1,688.46