Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,278.19 / $3,139.71 / $14,482.00	Facility		$1,278.19	$3,139.71	$14,482.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $958.64 / $958.64 / $2,354.78	Facility	54	$958.64	$958.64	$2,354.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $798.01 / $1,143.16 / $1,489.55	Professional		$798.01	$1,143.16	$1,489.55
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $119.70 / $191.73 / $223.43	Professional	55	$119.70	$191.73	$223.43
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,538.00 / $9,720.00 / $15,579.70	Facility		$6,538.00	$9,720.00	$15,579.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $843.96 / $1,650.31 / $3,989.10	Professional		$843.96	$1,650.31	$3,989.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,254.60 / $2,634.68 / $4,249.64	Facility		$2,254.60	$2,634.68	$4,249.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,025.32 / $2,064.15 / $3,082.04	Professional		$1,025.32	$2,064.15	$3,082.04
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $782.97 / $1,213.59 / $1,739.57	Facility		$782.97	$1,213.59	$1,739.57
Medica Facility/Professional Facility Modifier Low / Median / High Price $939.56 / $8,225.90 / $15,702.00	Facility		$939.56	$8,225.90	$15,702.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $893.22 / $1,703.32 / $5,957.21	Professional		$893.22	$1,703.32	$5,957.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $62.33 / $477.63 / $1,391.78	Professional		$62.33	$477.63	$1,391.78
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $782.97 / $1,213.59 / $1,739.57	Facility		$782.97	$1,213.59	$1,739.57
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,295.64 / $1,955.25 / $2,849.85	Professional		$1,295.64	$1,955.25	$2,849.85
Quartz Facility/Professional Facility Modifier Low / Median / High Price $21,343.05 / $21,343.05 / $21,343.05	Facility		$21,343.05	$21,343.05	$21,343.05
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $14,161.14 / $14,161.14 / $14,161.14	Facility	54	$14,161.14	$14,161.14	$14,161.14
Quartz Facility/Professional Professional Modifier Low / Median / High Price $918.82 / $3,625.92 / $6,370.48	Professional		$918.82	$3,625.92	$6,370.48
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,183.73 / $5,158.39 / $8,284.36	Professional		$3,183.73	$5,158.39	$8,284.36
United Facility/Professional Facility Modifier Low / Median / High Price $7,301.00 / $11,608.00 / $13,980.00	Facility		$7,301.00	$11,608.00	$13,980.00
United Facility/Professional Professional Modifier Low / Median / High Price $893.01 / $1,766.50 / $3,720.52	Professional		$893.01	$1,766.50	$3,720.52