Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $655.65 / $3,961.60 / $17,823.00	Facility		$655.65	$3,961.60	$17,823.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $8,243.00 / $14,061.64 / $32,484.06	Facility	50	$8,243.00	$14,061.64	$32,484.06
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $8,712.00 / $12,444.00 / $19,639.00	Facility		$8,712.00	$12,444.00	$19,639.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,034.80 / $1,562.13 / $1,562.13	Facility		$1,034.80	$1,562.13	$1,562.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,800.68 / $3,272.82 / $5,278.94	Facility		$2,800.68	$3,272.82	$5,278.94
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $904.69 / $1,475.47 / $3,658.43	Facility		$904.69	$1,475.47	$3,658.43
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,086.72 / $3,658.43 / $15,743.00	Facility		$1,086.72	$3,658.43	$15,743.00
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $13,864.39 / $16,369.92 / $21,788.30	Facility	50	$13,864.39	$16,369.92	$21,788.30
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $904.69 / $1,575.15 / $3,658.43	Facility		$904.69	$1,575.15	$3,658.43
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,154.75 / $3,026.94 / $3,919.32	Professional		$2,154.75	$3,026.94	$3,919.32
Quartz Facility/Professional Facility Modifier Low / Median / High Price $15,214.55 / $15,214.55 / $15,214.55	Facility		$15,214.55	$15,214.55	$15,214.55
Quartz Facility/Professional Facility Modifier AS Low / Median / High Price $1,442.13 / $1,442.13 / $1,442.13	Facility	AS	$1,442.13	$1,442.13	$1,442.13
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