Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $472.35 / $995.47 / $1,940.48	Facility		$472.35	$995.47	$1,940.48
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $354.26 / $387.15 / $1,455.36	Facility	54	$354.26	$387.15	$1,455.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $442.47 / $516.20 / $2,056.62	Professional		$442.47	$516.20	$2,056.62
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 $497.96 / $1,041.70 / $2,757.64	Professional		$497.96	$1,041.70	$2,757.64
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 $1,385.92 / $1,619.56 / $2,484.44	Facility		$1,385.92	$1,619.56	$2,484.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $708.41 / $1,688.45 / $2,400.03	Professional		$708.41	$1,688.45	$2,400.03
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $483.91 / $658.39 / $1,106.08	Facility		$483.91	$658.39	$1,106.08
Medica Facility/Professional Facility Modifier Low / Median / High Price $484.75 / $744.25 / $1,590.00	Facility		$484.75	$744.25	$1,590.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $561.74 / $1,177.58 / $3,926.40	Professional		$561.74	$1,177.58	$3,926.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $61.84 / $312.12 / $1,026.35	Professional		$61.84	$312.12	$1,026.35
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $483.91 / $647.48 / $1,106.08	Facility		$483.91	$647.48	$1,106.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,051.70 / $1,281.46 / $1,860.84	Professional		$1,051.70	$1,281.46	$1,860.84
Quartz Facility/Professional Facility Modifier Low / Median / High Price $264.92 / $264.92 / $2,860.50	Facility		$264.92	$264.92	$2,860.50
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $1,572.54 / $1,572.54 / $1,572.54	Facility	54	$1,572.54	$1,572.54	$1,572.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $958.49 / $2,289.44 / $3,926.40	Professional		$958.49	$2,289.44	$3,926.40
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,483.47 / $3,072.92 / $3,361.18	Professional		$1,483.47	$3,072.92	$3,361.18
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 $547.00 / $1,069.85 / $2,262.58	Professional		$547.00	$1,069.85	$2,262.58