Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $323.50 / $689.96 / $1,894.00	Facility		$323.50	$689.96	$1,894.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $242.63 / $261.95 / $996.74	Facility	54	$242.63	$261.95	$996.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $293.81 / $349.28 / $1,498.00	Professional		$293.81	$349.28	$1,498.00
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 $332.22 / $746.53 / $1,880.23	Professional		$332.22	$746.53	$1,880.23
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 $953.39 / $1,114.10 / $1,709.07	Facility		$953.39	$1,114.10	$1,709.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $425.79 / $1,180.59 / $1,576.69	Professional		$425.79	$1,180.59	$1,576.69
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $323.50 / $437.96 / $766.63	Facility		$323.50	$437.96	$766.63
Medica Facility/Professional Facility Modifier Low / Median / High Price $331.42 / $517.96 / $1,449.00	Facility		$331.42	$517.96	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $368.11 / $753.45 / $2,663.36	Professional		$368.11	$753.45	$2,663.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.65 / $210.53 / $696.82	Professional		$38.65	$210.53	$696.82
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $323.50 / $428.41 / $766.63	Facility		$323.50	$428.41	$766.63
Quartz Facility/Professional Professional Modifier Low / Median / High Price $713.70 / $869.62 / $1,246.89	Professional		$713.70	$869.62	$1,246.89
Quartz Facility/Professional Facility Modifier Low / Median / High Price $264.92 / $264.92 / $1,573.16	Facility		$264.92	$264.92	$1,573.16
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $1,078.76 / $1,078.76 / $1,078.76	Facility	54	$1,078.76	$1,078.76	$1,078.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $654.66 / $1,531.75 / $2,663.36	Professional		$654.66	$1,531.75	$2,663.36
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,022.36 / $2,126.73 / $2,295.77	Professional		$1,022.36	$2,126.73	$2,295.77
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 $364.49 / $696.40 / $1,507.64	Professional		$364.49	$696.40	$1,507.64