Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $396.95 / $846.11 / $3,119.00	Facility		$396.95	$846.11	$3,119.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $297.70 / $325.08 / $1,236.17	Facility	54	$297.70	$325.08	$1,236.17
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,183.00 / $3,483.00 / $5,962.00	Facility		$1,183.00	$3,483.00	$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 $1,179.57 / $1,378.42 / $2,114.53	Facility		$1,179.57	$1,378.42	$2,114.53
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $376.05 / $501.49 / $940.13	Facility		$376.05	$501.49	$940.13
Medica Facility/Professional Facility Modifier Low / Median / High Price $376.05 / $619.10 / $3,034.00	Facility		$376.05	$619.10	$3,034.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $376.05 / $493.24 / $940.13	Facility		$376.05	$493.24	$940.13
Quartz Facility/Professional Professional Modifier Low / Median / High Price $889.85 / $1,084.25 / $1,554.64	Professional		$889.85	$1,084.25	$1,554.64
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,722.47 / $1,722.47 / $2,421.10	Facility		$1,722.47	$1,722.47	$2,421.10
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $1,330.94 / $1,330.94 / $1,330.94	Facility	54	$1,330.94	$1,330.94	$1,330.94
United Facility/Professional Facility Modifier Low / Median / High Price $1,957.00 / $3,068.00 / $4,295.00	Facility		$1,957.00	$3,068.00	$4,295.00