Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $306.43 / $653.09 / $1,894.00	Facility		$306.43	$653.09	$1,894.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $229.82 / $239.36 / $901.83	Facility	54	$229.82	$239.36	$901.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $266.35 / $322.11 / $1,385.00	Professional		$266.35	$322.11	$1,385.00
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 $303.47 / $707.15 / $1,776.95	Professional		$303.47	$707.15	$1,776.95
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 $862.37 / $1,007.75 / $1,545.91	Facility		$862.37	$1,007.75	$1,545.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $413.52 / $957.31 / $1,485.55	Professional		$413.52	$957.31	$1,485.55
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $306.43 / $386.82 / $705.32	Facility		$306.43	$386.82	$705.32
Medica Facility/Professional Facility Modifier Low / Median / High Price $306.43 / $476.14 / $1,449.00	Facility		$306.43	$476.14	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $336.07 / $698.93 / $2,416.23	Professional		$336.07	$698.93	$2,416.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.65 / $183.42 / $623.64	Professional		$38.65	$183.42	$623.64
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $306.43 / $385.99 / $705.32	Facility		$306.43	$385.99	$705.32
Quartz Facility/Professional Professional Modifier Low / Median / High Price $646.75 / $796.20 / $1,176.39	Professional		$646.75	$796.20	$1,176.39
Quartz Facility/Professional Facility Modifier Low / Median / High Price $264.92 / $264.92 / $1,482.40	Facility		$264.92	$264.92	$1,482.40
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $1,021.52 / $1,021.52 / $1,021.52	Facility	54	$1,021.52	$1,021.52	$1,021.52
Quartz Facility/Professional Professional Modifier Low / Median / High Price $593.27 / $1,460.95 / $2,416.23	Professional		$593.27	$1,460.95	$2,416.23
Security Health Facility/Professional Professional Modifier Low / Median / High Price $973.24 / $2,006.75 / $2,080.46	Professional		$973.24	$2,006.75	$2,080.46
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 $311.37 / $955.04 / $1,786.18	Professional		$311.37	$955.04	$1,786.18