Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $403.93 / $854.57 / $14,482.00	Facility		$403.93	$854.57	$14,482.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $302.95 / $302.95 / $1,142.28	Facility	54	$302.95	$302.95	$1,142.28
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,905.00 / $3,496.00 / $5,962.00	Facility		$1,905.00	$3,496.00	$5,962.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,942.50 / $1,942.50 / $1,942.50	Facility		$1,942.50	$1,942.50	$1,942.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,089.45 / $1,273.10 / $1,952.99	Facility		$1,089.45	$1,273.10	$1,952.99
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $379.81 / $501.50 / $949.53	Facility		$379.81	$501.50	$949.53
Medica Facility/Professional Facility Modifier Low / Median / High Price $379.81 / $816.59 / $5,261.00	Facility		$379.81	$816.59	$5,261.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $379.81 / $501.50 / $949.53	Facility		$379.81	$501.50	$949.53
Quartz Facility/Professional Professional Modifier Low / Median / High Price $824.85 / $1,005.05 / $1,500.34	Professional		$824.85	$1,005.05	$1,500.34
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,722.47 / $1,722.47 / $4,754.80	Facility		$1,722.47	$1,722.47	$4,754.80
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $3,154.80 / $3,154.80 / $3,154.80	Facility	54	$3,154.80	$3,154.80	$3,154.80
United Facility/Professional Facility Modifier Low / Median / High Price $2,723.00 / $4,092.17 / $5,865.00	Facility		$2,723.00	$4,092.17	$5,865.00