Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $308.38 / $662.02 / $1,894.00	Facility		$308.38	$662.02	$1,894.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $231.29 / $251.12 / $961.23	Facility	54	$231.29	$251.12	$961.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $284.37 / $334.83 / $1,468.00	Professional		$284.37	$334.83	$1,468.00
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 $321.19 / $703.45 / $1,799.07	Professional		$321.19	$703.45	$1,799.07
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 $919.14 / $1,074.08 / $1,647.68	Facility		$919.14	$1,074.08	$1,647.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $400.44 / $966.29 / $1,546.13	Professional		$400.44	$966.29	$1,546.13
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $294.23 / $389.33 / $735.58	Facility		$294.23	$389.33	$735.58
Medica Facility/Professional Facility Modifier Low / Median / High Price $294.23 / $479.42 / $1,449.00	Facility		$294.23	$479.42	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $353.74 / $735.98 / $2,561.19	Professional		$353.74	$735.98	$2,561.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.65 / $202.77 / $681.31	Professional		$38.65	$202.77	$681.31
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $294.23 / $383.53 / $735.58	Facility		$294.23	$383.53	$735.58
Quartz Facility/Professional Professional Modifier Low / Median / High Price $686.40 / $836.35 / $1,199.19	Professional		$686.40	$836.35	$1,199.19
Quartz Facility/Professional Facility Modifier Low / Median / High Price $264.92 / $264.92 / $1,500.88	Facility		$264.92	$264.92	$1,500.88
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $1,032.09 / $1,032.09 / $1,032.09	Facility	54	$1,032.09	$1,032.09	$1,032.09
Quartz Facility/Professional Professional Modifier Low / Median / High Price $630.45 / $1,474.85 / $2,561.19	Professional		$630.45	$1,474.85	$2,561.19
Security Health Facility/Professional Professional Modifier Low / Median / High Price $980.35 / $2,035.31 / $2,210.84	Professional		$980.35	$2,035.31	$2,210.84
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 $345.02 / $641.32 / $1,459.00	Professional		$345.02	$641.32	$1,459.00