Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $491.03 / $1,039.95 / $1,962.65	Facility		$491.03	$1,039.95	$1,962.65
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $368.27 / $389.37 / $1,471.99	Facility	54	$368.27	$389.37	$1,471.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $490.22 / $527.49 / $2,266.92	Professional		$490.22	$527.49	$2,266.92
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 $502.01 / $1,133.16 / $2,874.48	Professional		$502.01	$1,133.16	$2,874.48
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 $1,401.24 / $1,637.46 / $2,511.91	Facility		$1,401.24	$1,637.46	$2,511.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $658.91 / $1,575.75 / $2,423.54	Professional		$658.91	$1,575.75	$2,423.54
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $491.03 / $651.97 / $1,147.33	Facility		$491.03	$651.97	$1,147.33
Medica Facility/Professional Facility Modifier Low / Median / High Price $491.03 / $736.55 / $1,590.00	Facility		$491.03	$736.55	$1,590.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $566.80 / $1,189.96 / $3,960.88	Professional		$566.80	$1,189.96	$3,960.88
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 $491.03 / $649.51 / $1,147.33	Facility		$491.03	$649.51	$1,147.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,062.75 / $1,305.82 / $1,915.53	Professional		$1,062.75	$1,305.82	$1,915.53
Quartz Facility/Professional Facility Modifier Low / Median / High Price $264.92 / $264.92 / $2,977.90	Facility		$264.92	$264.92	$2,977.90
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $1,639.31 / $1,639.31 / $1,639.31	Facility	54	$1,639.31	$1,639.31	$1,639.31
Quartz Facility/Professional Professional Modifier Low / Median / High Price $967.86 / $2,371.25 / $3,960.88	Professional		$967.86	$2,371.25	$3,960.88
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,549.76 / $3,205.50 / $3,394.03	Professional		$1,549.76	$3,205.50	$3,394.03
United Facility/Professional Facility Modifier Low / Median / High Price $1,034.00 / $1,423.00 / $2,202.90	Facility		$1,034.00	$1,423.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $551.42 / $1,022.65 / $2,205.71	Professional		$551.42	$1,022.65	$2,205.71