Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $286.51 / $612.74 / $1,894.00	Facility		$286.51	$612.74	$1,894.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $214.88 / $233.96 / $891.63	Facility	54	$214.88	$233.96	$891.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $277.42 / $320.01 / $1,290.35	Professional		$277.42	$320.01	$1,290.35
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 $294.24 / $645.66 / $1,666.53	Professional		$294.24	$645.66	$1,666.53
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 $853.36 / $997.22 / $1,529.76	Facility		$853.36	$997.22	$1,529.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $365.91 / $1,050.34 / $1,433.59	Professional		$365.91	$1,050.34	$1,433.59
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $269.19 / $356.83 / $680.83	Facility		$269.19	$356.83	$680.83
Medica Facility/Professional Facility Modifier Low / Median / High Price $272.33 / $434.18 / $1,449.00	Facility		$272.33	$434.18	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $319.68 / $676.19 / $2,375.12	Professional		$319.68	$676.19	$2,375.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.65 / $182.56 / $593.82	Professional		$38.65	$182.56	$593.82
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $269.19 / $355.76 / $680.83	Facility		$269.19	$355.76	$680.83
Quartz Facility/Professional Professional Modifier Low / Median / High Price $637.65 / $776.95 / $1,114.02	Professional		$637.65	$776.95	$1,114.02
Quartz Facility/Professional Facility Modifier Low / Median / High Price $264.92 / $264.92 / $1,390.80	Facility		$264.92	$264.92	$1,390.80
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $956.89 / $956.89 / $956.89	Facility	54	$956.89	$956.89	$956.89
Quartz Facility/Professional Professional Modifier Low / Median / High Price $584.88 / $1,356.66 / $2,375.12	Professional		$584.88	$1,356.66	$2,375.12
Security Health Facility/Professional Professional Modifier Low / Median / High Price $898.45 / $1,884.13 / $2,051.01	Professional		$898.45	$1,884.13	$2,051.01
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 $317.58 / $624.01 / $1,346.85	Professional		$317.58	$624.01	$1,346.85