Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.07 / $194.81 / $1,894.00	Facility		$91.07	$194.81	$1,894.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $68.30 / $92.41 / $353.50	Facility	54	$68.30	$92.41	$353.50
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
CareSource Facility/Professional Facility Modifier Low / Median / High Price $192.61 / $192.61 / $192.61	Facility		$192.61	$192.61	$192.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $337.92 / $394.89 / $605.77	Facility		$337.92	$394.89	$605.77
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $88.62 / $136.61 / $263.45	Facility		$88.62	$136.61	$263.45
Medica Facility/Professional Facility Modifier Low / Median / High Price $88.62 / $158.69 / $1,449.00	Facility		$88.62	$158.69	$1,449.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $88.62 / $136.61 / $263.45	Facility		$88.62	$136.61	$263.45
Quartz Facility/Professional Professional Modifier Low / Median / High Price $210.06 / $300.04 / $437.31	Professional		$210.06	$300.04	$437.31
Quartz Facility/Professional Facility Modifier Low / Median / High Price $158.16 / $158.16 / $437.49	Facility		$158.16	$158.16	$437.49
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $306.24 / $306.24 / $306.24	Facility	54	$306.24	$306.24	$306.24
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