Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $483.34 / $610.13 / $1,998.66	Facility		$483.34	$610.13	$1,998.66
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $362.51 / $397.91 / $1,499.00	Facility	54	$362.51	$397.91	$1,499.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $459.03 / $530.54 / $1,971.82	Professional		$459.03	$530.54	$1,971.82
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,740.00 / $4,780.00 / $7,344.00	Facility		$2,740.00	$4,780.00	$7,344.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $513.09 / $986.05 / $2,825.52	Professional		$513.09	$986.05	$2,825.52
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 $1,430.08 / $1,671.16 / $2,563.60	Facility		$1,430.08	$1,671.16	$2,563.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $675.42 / $1,524.84 / $2,474.10	Professional		$675.42	$1,524.84	$2,474.10
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $497.09 / $676.68 / $1,133.83	Facility		$497.09	$676.68	$1,133.83
Medica Facility/Professional Facility Modifier Low / Median / High Price $498.42 / $782.20 / $4,292.39	Facility		$498.42	$782.20	$4,292.39
Medica Facility/Professional Professional Modifier Low / Median / High Price $579.37 / $1,174.22 / $4,043.60	Professional		$579.37	$1,174.22	$4,043.60
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 $497.09 / $665.54 / $1,133.83	Facility		$497.09	$665.54	$1,133.83
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,082.25 / $1,318.68 / $1,911.52	Professional		$1,082.25	$1,318.68	$1,911.52
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,722.47 / $1,722.47 / $2,344.88	Facility		$1,722.47	$1,722.47	$2,344.88
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $1,610.71 / $1,610.71 / $1,610.71	Facility	54	$1,610.71	$1,610.71	$1,610.71
Quartz Facility/Professional Professional Modifier Low / Median / High Price $988.07 / $2,347.40 / $4,043.60	Professional		$988.07	$2,347.40	$4,043.60
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,520.69 / $3,150.65 / $3,464.92	Professional		$1,520.69	$3,150.65	$3,464.92
United Facility/Professional Facility Modifier Low / Median / High Price $2,960.00 / $4,155.00 / $5,865.00	Facility		$2,960.00	$4,155.00	$5,865.00
United Facility/Professional Professional Modifier Low / Median / High Price $578.27 / $1,123.11 / $2,454.81	Professional		$578.27	$1,123.11	$2,454.81