Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $144.02 / $309.62 / $1,894.00	Facility		$144.02	$309.62	$1,894.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $108.02 / $123.83 / $473.44	Facility	54	$108.02	$123.83	$473.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $136.03 / $165.11 / $630.41	Professional		$136.03	$165.11	$630.41
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 $159.97 / $288.02 / $874.15	Professional		$159.97	$288.02	$874.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $292.86 / $292.86 / $292.86	Facility		$292.86	$292.86	$292.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $455.97 / $532.83 / $817.38	Facility		$455.97	$532.83	$817.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.55 / $505.41 / $765.35	Professional		$199.55	$505.41	$765.35
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $142.16 / $195.47 / $354.20	Facility		$142.16	$195.47	$354.20
Medica Facility/Professional Facility Modifier Low / Median / High Price $144.02 / $236.13 / $1,449.00	Facility		$144.02	$236.13	$1,449.00
Medica Facility/Professional Facility Modifier 54 Low / Median / High Price $629.09 / $629.09 / $629.09	Facility	54	$629.09	$629.09	$629.09
Medica Facility/Professional Professional Modifier Low / Median / High Price $170.79 / $357.17 / $1,264.80	Professional		$170.79	$357.17	$1,264.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.53 / $120.84 / $338.03	Professional		$31.53	$120.84	$338.03
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $142.16 / $193.18 / $354.20	Facility		$142.16	$193.18	$354.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $318.31 / $405.50 / $581.42	Professional		$318.31	$405.50	$581.42
Quartz Facility/Professional Facility Modifier Low / Median / High Price $225.98 / $225.98 / $697.92	Facility		$225.98	$225.98	$697.92
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $474.73 / $474.73 / $474.73	Facility	54	$474.73	$474.73	$474.73
Quartz Facility/Professional Professional Modifier Low / Median / High Price $299.72 / $725.22 / $1,264.80	Professional		$299.72	$725.22	$1,264.80
Security Health Facility/Professional Professional Modifier Low / Median / High Price $461.41 / $955.51 / $1,096.39	Professional		$461.41	$955.51	$1,096.39
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 $168.54 / $317.48 / $719.16	Professional		$168.54	$317.48	$719.16