Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $423.21 / $1,002.89 / $4,770.21	Facility		$423.21	$1,002.89	$4,770.21
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $317.41 / $354.07 / $1,340.54	Facility	54	$317.41	$354.07	$1,340.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $423.21 / $488.73 / $1,787.38	Professional		$423.21	$488.73	$1,787.38
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,183.00 / $3,483.00 / $5,962.00	Facility		$1,183.00	$3,483.00	$5,962.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $450.05 / $976.63 / $2,460.08	Professional		$450.05	$976.63	$2,460.08
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 $1,279.58 / $1,495.30 / $2,293.83	Facility		$1,279.58	$1,495.30	$2,293.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $604.88 / $1,320.81 / $2,125.11	Professional		$604.88	$1,320.81	$2,125.11
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $435.69 / $634.82 / $1,002.89	Facility		$435.69	$634.82	$1,002.89
Medica Facility/Professional Facility Modifier Low / Median / High Price $442.22 / $708.14 / $3,326.00	Facility		$442.22	$708.14	$3,326.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $510.74 / $1,028.61 / $3,606.48	Professional		$510.74	$1,028.61	$3,606.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $61.84 / $292.51 / $915.74	Professional		$61.84	$292.51	$915.74
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $435.69 / $630.07 / $1,002.89	Facility		$435.69	$630.07	$1,002.89
Quartz Facility/Professional Professional Modifier Low / Median / High Price $963.24 / $1,176.91 / $1,687.50	Professional		$963.24	$1,176.91	$1,687.50
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,722.47 / $1,722.47 / $2,061.40	Facility		$1,722.47	$1,722.47	$2,061.40
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $1,415.72 / $1,415.72 / $1,415.72	Facility	54	$1,415.72	$1,415.72	$1,415.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $876.60 / $2,047.01 / $3,606.48	Professional		$876.60	$2,047.01	$3,606.48
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,338.85 / $2,771.73 / $3,094.70	Professional		$1,338.85	$2,771.73	$3,094.70
United Facility/Professional Facility Modifier Low / Median / High Price $2,367.00 / $3,088.30 / $4,295.00	Facility		$2,367.00	$3,088.30	$4,295.00
United Facility/Professional Professional Modifier Low / Median / High Price $501.83 / $920.02 / $2,039.13	Professional		$501.83	$920.02	$2,039.13