Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $125.48 / $270.08 / $1,894.00	Facility		$125.48	$270.08	$1,894.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $94.11 / $106.91 / $410.37	Facility	54	$94.11	$106.91	$410.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $118.33 / $142.55 / $574.16	Professional		$118.33	$142.55	$574.16
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 $140.61 / $289.56 / $724.96	Professional		$140.61	$289.56	$724.96
CareSource Facility/Professional Facility Modifier Low / Median / High Price $277.98 / $277.98 / $277.98	Facility		$277.98	$277.98	$277.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $393.79 / $460.17 / $705.92	Facility		$393.79	$460.17	$705.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $175.77 / $439.01 / $672.85	Professional		$175.77	$439.01	$672.85
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $120.04 / $163.74 / $307.82	Facility		$120.04	$163.74	$307.82
Medica Facility/Professional Facility Modifier Low / Median / High Price $120.04 / $196.85 / $1,449.00	Facility		$120.04	$196.85	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $148.80 / $316.58 / $1,086.00	Professional		$148.80	$316.58	$1,086.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.95 / $92.82 / $281.96	Professional		$28.95	$92.82	$281.96
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $120.04 / $163.74 / $307.82	Facility		$120.04	$163.74	$307.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $278.33 / $353.23 / $506.48	Professional		$278.33	$353.23	$506.48
Quartz Facility/Professional Facility Modifier Low / Median / High Price $208.02 / $208.02 / $605.96	Facility		$208.02	$208.02	$605.96
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $416.44 / $416.44 / $416.44	Facility	54	$416.44	$416.44	$416.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $259.55 / $623.29 / $1,086.00	Professional		$259.55	$623.29	$1,086.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $402.49 / $827.43 / $942.31	Professional		$402.49	$827.43	$942.31
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 $146.88 / $283.62 / $627.58	Professional		$146.88	$283.62	$627.58