Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $306.10 / $1,014.93 / $6,400.79	Facility		$306.10	$1,014.93	$6,400.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $292.64 / $495.60 / $1,606.50	Professional		$292.64	$495.60	$1,606.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,740.00 / $4,780.00 / $7,344.00	Facility		$2,740.00	$4,780.00	$7,344.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $387.77 / $706.40 / $1,795.19	Professional		$387.77	$706.40	$1,795.19
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,507.48 / $1,507.48 / $1,507.48	Facility		$1,507.48	$1,507.48	$1,507.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,331.86 / $1,556.38 / $2,387.52	Facility		$1,331.86	$1,556.38	$2,387.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $519.42 / $1,205.33 / $2,280.81	Professional		$519.42	$1,205.33	$2,280.81
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $306.10 / $495.61 / $1,015.94	Facility		$306.10	$495.61	$1,015.94
Medica Facility/Professional Facility Modifier Low / Median / High Price $306.10 / $579.85 / $6,669.00	Facility		$306.10	$579.85	$6,669.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $503.09 / $1,068.90 / $5,618.43	Professional		$503.09	$1,068.90	$5,618.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $52.59 / $295.24 / $944.26	Professional		$52.59	$295.24	$944.26
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $306.10 / $495.61 / $1,015.94	Facility		$306.10	$495.61	$1,015.94
Quartz Facility/Professional Professional Modifier Low / Median / High Price $737.53 / $1,140.24 / $1,680.68	Professional		$737.53	$1,140.24	$1,680.68
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,455.33 / $1,455.33 / $1,492.04	Facility		$1,455.33	$1,455.33	$1,492.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $655.90 / $2,112.84 / $5,618.43	Professional		$655.90	$2,112.84	$5,618.43
Security Health Facility/Professional Professional Modifier Low / Median / High Price $964.46 / $2,000.11 / $3,194.22	Professional		$964.46	$2,000.11	$3,194.22
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 $502.78 / $903.48 / $2,049.12	Professional		$502.78	$903.48	$2,049.12