Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,242.64 / $1,894.00 / $14,482.00	Facility		$1,242.64	$1,894.00	$14,482.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $931.98 / $931.98 / $2,257.55	Facility	54	$931.98	$931.98	$2,257.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $599.08 / $1,074.91 / $1,947.77	Professional		$599.08	$1,074.91	$1,947.77
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $115.58 / $186.40 / $571.94	Professional	55	$115.58	$186.40	$571.94
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,183.00 / $9,096.00 / $15,579.70	Facility		$1,183.00	$9,096.00	$15,579.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $742.42 / $1,604.42 / $3,768.42	Professional		$742.42	$1,604.42	$3,768.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,200.54 / $2,571.50 / $4,147.74	Facility		$2,200.54	$2,571.50	$4,147.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $940.75 / $1,995.68 / $2,983.20	Professional		$940.75	$1,995.68	$2,983.20
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $753.70 / $1,072.86 / $1,491.17	Facility		$753.70	$1,072.86	$1,491.17
Medica Facility/Professional Facility Modifier Low / Median / High Price $789.37 / $4,103.00 / $8,783.00	Facility		$789.37	$4,103.00	$8,783.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $750.64 / $1,604.79 / $6,128.88	Professional		$750.64	$1,604.79	$6,128.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $62.75 / $431.48 / $1,374.18	Professional		$62.75	$431.48	$1,374.18
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $750.64 / $1,072.86 / $1,681.90	Facility		$750.64	$1,072.86	$1,681.90
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,458.00 / $1,924.56 / $2,731.81	Professional		$1,458.00	$1,924.56	$2,731.81
Quartz Facility/Professional Facility Modifier Low / Median / High Price $11,879.05 / $11,879.05 / $11,879.05	Facility		$11,879.05	$11,879.05	$11,879.05
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $7,881.75 / $7,881.75 / $7,881.75	Facility	54	$7,881.75	$7,881.75	$7,881.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,364.85 / $3,812.95 / $6,128.88	Professional		$1,364.85	$3,812.95	$6,128.88
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,865.78 / $5,042.85 / $8,018.67	Professional		$2,865.78	$5,042.85	$8,018.67
United Facility/Professional Facility Modifier Low / Median / High Price $4,918.00 / $6,477.00 / $8,384.00	Facility		$4,918.00	$6,477.00	$8,384.00
United Facility/Professional Professional Modifier Low / Median / High Price $786.02 / $1,633.51 / $3,401.15	Professional		$786.02	$1,633.51	$3,401.15