Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $426.58 / $1,905.46	Facility		$120.23	$426.58	$1,905.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $169.82 / $363.08	Professional		$109.65	$169.82	$363.08
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $114.82 / $218.78 / $489.78	Professional	54	$114.82	$218.78	$489.78
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $3,090.30 / $5,754.40	Facility		$1,584.89	$3,090.30	$5,754.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $239.88 / $588.84	Professional		$120.23	$239.88	$588.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $389.05 / $630.96	Facility		$338.84	$389.05	$630.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $512.86 / $588.84	Professional		$144.54	$512.86	$588.84
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $186.21 / $3,311.31	Facility		$120.23	$186.21	$3,311.31
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $316.23 / $398.11	Professional		$223.87	$316.23	$398.11
DeanCare Facility/Professional Professional Modifier 54 Low / Median / High Price $177.83 / $251.19 / $316.23	Professional	54	$177.83	$251.19	$316.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $194.98 / $1,659.59	Facility		$120.23	$194.98	$1,659.59
Medica Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $239.88 / $933.25	Professional		$120.23	$239.88	$933.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $154.88	Professional		$32.36	$33.11	$154.88
Quartz Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $316.23 / $457.09	Professional		$208.93	$316.23	$457.09
Quartz Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $354.81 / $2,187.76	Facility		$165.96	$354.81	$2,187.76
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $229.09 / $229.09 / $524.81	Facility	54	$229.09	$229.09	$524.81
Quartz Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $588.84 / $912.01	Professional		$204.17	$588.84	$912.01
Security Health Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $812.83 / $812.83	Professional		$125.89	$812.83	$812.83
United Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $1,548.82 / $1,949.84	Facility		$977.24	$1,548.82	$1,949.84
United Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $181.97 / $501.19	Professional		$120.23	$181.97	$501.19