Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $191.71 / $411.50 / $1,894.00	Facility		$191.71	$411.50	$1,894.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $143.78 / $159.11 / $607.76	Facility	54	$143.78	$159.11	$607.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $181.19 / $212.14 / $775.91	Professional		$181.19	$212.14	$775.91
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 $199.47 / $383.42 / $1,174.46	Professional		$199.47	$383.42	$1,174.46
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 $583.92 / $682.36 / $1,046.76	Facility		$583.92	$682.36	$1,046.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $300.55 / $647.12 / $1,001.96	Professional		$300.55	$647.12	$1,001.96
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $191.71 / $258.66 / $457.23	Facility		$191.71	$258.66	$457.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $191.71 / $307.29 / $1,449.00	Facility		$191.71	$307.29	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $230.01 / $473.40 / $1,621.44	Professional		$230.01	$473.40	$1,621.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.53 / $153.19 / $414.04	Professional		$31.53	$153.19	$414.04
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $191.71 / $257.08 / $457.23	Facility		$191.71	$257.08	$457.23
Quartz Facility/Professional Professional Modifier Low / Median / High Price $429.95 / $524.29 / $755.14	Professional		$429.95	$524.29	$755.14
Quartz Facility/Professional Facility Modifier Low / Median / High Price $264.92 / $264.92 / $929.84	Facility		$264.92	$264.92	$929.84
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $635.79 / $635.79 / $635.79	Facility	54	$635.79	$635.79	$635.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $398.57 / $928.17 / $1,621.44	Professional		$398.57	$928.17	$1,621.44
Security Health Facility/Professional Professional Modifier Low / Median / High Price $613.23 / $1,268.81 / $1,403.19	Professional		$613.23	$1,268.81	$1,403.19
United Facility/Professional Facility Modifier Low / Median / High Price $1,034.00 / $1,423.00 / $2,202.90	Facility		$1,034.00	$1,423.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $228.31 / $436.74 / $934.07	Professional		$228.31	$436.74	$934.07