Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $434.34 / $1,155.70 / $4,289.97	Facility		$434.34	$1,155.70	$4,289.97
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $325.76 / $366.94 / $1,391.21	Facility	54	$325.76	$366.94	$1,391.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $413.75 / $501.77 / $1,952.79	Professional		$413.75	$501.77	$1,952.79
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 $467.68 / $1,002.33 / $2,524.04	Professional		$467.68	$1,002.33	$2,524.04
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 $1,324.65 / $1,547.95 / $2,374.60	Facility		$1,324.65	$1,547.95	$2,374.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $627.69 / $1,472.63 / $2,290.34	Professional		$627.69	$1,472.63	$2,290.34
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $446.56 / $617.46 / $1,040.81	Facility		$446.56	$617.46	$1,040.81
Medica Facility/Professional Facility Modifier Low / Median / High Price $455.38 / $703.02 / $3,026.00	Facility		$455.38	$703.02	$3,026.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $528.02 / $1,067.15 / $3,741.04	Professional		$528.02	$1,067.15	$3,741.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $61.84 / $308.66 / $996.97	Professional		$61.84	$308.66	$996.97
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $446.56 / $615.10 / $1,040.81	Facility		$446.56	$615.10	$1,040.81
Quartz Facility/Professional Professional Modifier Low / Median / High Price $988.89 / $1,222.84 / $1,753.37	Professional		$988.89	$1,222.84	$1,753.37
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,722.47 / $1,722.47 / $2,116.52	Facility		$1,722.47	$1,722.47	$2,116.52
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $1,455.99 / $1,455.99 / $1,455.99	Facility	54	$1,455.99	$1,455.99	$1,455.99
Quartz Facility/Professional Professional Modifier Low / Median / High Price $899.17 / $2,121.66 / $3,741.04	Professional		$899.17	$2,121.66	$3,741.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,374.60 / $2,843.44 / $3,207.57	Professional		$1,374.60	$2,843.44	$3,207.57
United Facility/Professional Facility Modifier Low / Median / High Price $1,957.00 / $3,068.00 / $4,295.00	Facility		$1,957.00	$3,068.00	$4,295.00
United Facility/Professional Professional Modifier Low / Median / High Price $465.79 / $1,208.86 / $2,537.15	Professional		$465.79	$1,208.86	$2,537.15