Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $121.13 / $261.50 / $1,894.00	Facility		$121.13	$261.50	$1,894.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $90.85 / $91.35 / $349.53	Facility	54	$90.85	$91.35	$349.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.62 / $121.80 / $524.00	Professional		$104.62	$121.80	$524.00
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $89.51 / $91.35 / $479.69	Professional	54	$89.51	$91.35	$479.69
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 $120.01 / $279.52 / $731.76	Professional		$120.01	$279.52	$731.76
CareSource Facility/Professional Facility Modifier Low / Median / High Price $219.41 / $219.41 / $219.41	Facility		$219.41	$219.41	$219.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $335.22 / $391.73 / $600.91	Facility		$335.22	$391.73	$600.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $155.29 / $505.37 / $575.84	Professional		$155.29	$505.37	$575.84
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $116.22 / $148.76 / $269.18	Facility		$116.22	$148.76	$269.18
Medica Facility/Professional Facility Modifier Low / Median / High Price $116.22 / $187.43 / $1,455.00	Facility		$116.22	$187.43	$1,455.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $128.63 / $265.64 / $931.20	Professional		$128.63	$265.64	$931.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.84 / $72.74 / $219.68	Professional		$25.84	$72.74	$219.68
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $116.22 / $147.27 / $269.18	Facility		$116.22	$147.27	$269.18
Quartz Facility/Professional Professional Modifier Low / Median / High Price $247.00 / $320.76 / $495.09	Professional		$247.00	$320.76	$495.09
Quartz Facility/Professional Facility Modifier Low / Median / High Price $164.83 / $164.83 / $2,165.76	Facility		$164.83	$164.83	$2,165.76
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $301.91 / $301.91 / $301.91	Facility	54	$301.91	$301.91	$301.91
Quartz Facility/Professional Professional Modifier Low / Median / High Price $249.33 / $580.00 / $931.20	Professional		$249.33	$580.00	$931.20
Security Health Facility/Professional Professional Modifier Low / Median / High Price $389.69 / $804.26 / $806.41	Professional		$389.69	$804.26	$806.41
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 $125.23 / $241.96 / $537.16	Professional		$125.23	$241.96	$537.16