Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,350.42 / $3,008.00 / $14,482.00	Facility		$1,350.42	$3,008.00	$14,482.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $1,012.82 / $1,012.82 / $2,481.64	Facility	54	$1,012.82	$1,012.82	$2,481.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $738.41 / $957.17 / $2,173.07	Professional		$738.41	$957.17	$2,173.07
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $130.16 / $202.56 / $660.26	Professional	55	$130.16	$202.56	$660.26
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,740.00 / $3,876.00 / $5,962.00	Facility		$2,740.00	$3,876.00	$5,962.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $881.49 / $1,743.58 / $4,211.22	Professional		$881.49	$1,743.58	$4,211.22
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,084.85 / $3,084.85 / $3,084.85	Facility		$3,084.85	$3,084.85	$3,084.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,382.56 / $2,784.21 / $4,490.83	Facility		$2,382.56	$2,784.21	$4,490.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,053.98 / $2,178.00 / $3,252.51	Professional		$1,053.98	$2,178.00	$3,252.51
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $867.70 / $1,246.42 / $1,835.99	Facility		$867.70	$1,246.42	$1,835.99
Medica Facility/Professional Facility Modifier Low / Median / High Price $919.83 / $3,353.00 / $8,103.00	Facility		$919.83	$3,353.00	$8,103.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $891.95 / $1,927.97 / $6,715.76	Professional		$891.95	$1,927.97	$6,715.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $62.75 / $506.97 / $1,510.67	Professional		$62.75	$506.97	$1,510.67
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $867.70 / $1,246.42 / $2,260.56	Facility		$867.70	$1,246.42	$2,260.56
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,603.20 / $2,116.21 / $3,003.86	Professional		$1,603.20	$2,116.21	$3,003.86
Quartz Facility/Professional Facility Modifier Low / Median / High Price $6,887.55 / $6,887.55 / $6,887.55	Facility		$6,887.55	$6,887.55	$6,887.55
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $4,569.92 / $4,569.92 / $4,569.92	Facility	54	$4,569.92	$4,569.92	$4,569.92
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,488.08 / $4,401.75 / $6,715.76	Professional		$1,488.08	$4,401.75	$6,715.76
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,952.73 / $5,445.66 / $8,742.58	Professional		$2,952.73	$5,445.66	$8,742.58
United Facility/Professional Facility Modifier Low / Median / High Price $3,078.00 / $5,918.00 / $7,791.00	Facility		$3,078.00	$5,918.00	$7,791.00
United Facility/Professional Professional Modifier Low / Median / High Price $874.79 / $1,663.86 / $3,858.13	Professional		$874.79	$1,663.86	$3,858.13