Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $307.50 / $656.57 / $1,894.00	Facility		$307.50	$656.57	$1,894.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $230.63 / $253.48 / $967.01	Facility	54	$230.63	$253.48	$967.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $283.80 / $337.97 / $1,155.90	Professional		$283.80	$337.97	$1,155.90
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 $321.73 / $709.63 / $1,790.90	Professional		$321.73	$709.63	$1,790.90
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 $927.25 / $1,083.57 / $1,662.22	Facility		$927.25	$1,083.57	$1,662.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $423.83 / $1,030.64 / $1,591.35	Professional		$423.83	$1,030.64	$1,591.35
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $291.81 / $385.84 / $729.53	Facility		$291.81	$385.84	$729.53
Medica Facility/Professional Facility Modifier Low / Median / High Price $291.81 / $471.60 / $1,449.00	Facility		$291.81	$471.60	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $352.74 / $721.51 / $2,579.60	Professional		$352.74	$721.51	$2,579.60
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 $291.81 / $385.84 / $729.53	Facility		$291.81	$385.84	$729.53
Quartz Facility/Professional Professional Modifier Low / Median / High Price $690.95 / $841.90 / $1,207.14	Professional		$690.95	$841.90	$1,207.14
Quartz Facility/Professional Facility Modifier Low / Median / High Price $264.92 / $264.92 / $1,492.48	Facility		$264.92	$264.92	$1,492.48
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $1,024.70 / $1,024.70 / $1,024.70	Facility	54	$1,024.70	$1,024.70	$1,024.70
Quartz Facility/Professional Professional Modifier Low / Median / High Price $635.52 / $1,474.16 / $2,579.60	Professional		$635.52	$1,474.16	$2,579.60
Security Health Facility/Professional Professional Modifier Low / Median / High Price $967.29 / $2,022.72 / $2,228.61	Professional		$967.29	$2,022.72	$2,228.61
United Facility/Professional Facility Modifier Low / Median / High Price $1,008.00 / $1,370.00 / $2,202.90	Facility		$1,008.00	$1,370.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $345.38 / $642.79 / $1,459.05	Professional		$345.38	$642.79	$1,459.05