Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $211.35 / $451.62 / $1,894.00	Facility		$211.35	$451.62	$1,894.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $158.51 / $181.11 / $687.45	Facility	54	$158.51	$181.11	$687.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.80 / $241.48 / $968.86	Professional		$199.80	$241.48	$968.86
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 $231.06 / $487.72 / $1,232.30	Professional		$231.06	$487.72	$1,232.30
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 $660.52 / $771.87 / $1,184.07	Facility		$660.52	$771.87	$1,184.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $327.43 / $801.47 / $1,133.41	Professional		$327.43	$801.47	$1,133.41
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $211.35 / $284.86 / $514.30	Facility		$211.35	$284.86	$514.30
Medica Facility/Professional Facility Modifier Low / Median / High Price $215.25 / $339.14 / $1,449.00	Facility		$215.25	$339.14	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $251.05 / $529.66 / $1,835.84	Professional		$251.05	$529.66	$1,835.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.53 / $182.42 / $484.25	Professional		$31.53	$182.42	$484.25
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $211.35 / $283.50 / $514.30	Facility		$211.35	$283.50	$514.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $475.21 / $595.58 / $853.97	Professional		$475.21	$595.58	$853.97
Quartz Facility/Professional Facility Modifier Low / Median / High Price $264.92 / $264.92 / $1,023.04	Facility		$264.92	$264.92	$1,023.04
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $701.49 / $701.49 / $701.49	Facility	54	$701.49	$701.49	$701.49
Quartz Facility/Professional Professional Modifier Low / Median / High Price $439.22 / $1,049.94 / $1,835.84	Professional		$439.22	$1,049.94	$1,835.84
Security Health Facility/Professional Professional Modifier Low / Median / High Price $673.01 / $1,390.12 / $1,587.29	Professional		$673.01	$1,390.12	$1,587.29
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 $247.21 / $483.76 / $1,050.00	Professional		$247.21	$483.76	$1,050.00