Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $339.63 / $723.96 / $1,894.00	Facility		$339.63	$723.96	$1,894.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $254.72 / $282.60 / $1,071.96	Facility	54	$254.72	$282.60	$1,071.96
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,139.00 / $2,479.00 / $4,441.52	Facility		$1,139.00	$2,479.00	$4,441.52
CareSource Facility/Professional Facility Modifier Low / Median / High Price $319.44 / $319.44 / $319.44	Facility		$319.44	$319.44	$319.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,018.27 / $1,189.92 / $1,825.37	Facility		$1,018.27	$1,189.92	$1,825.37
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $321.76 / $427.72 / $804.40	Facility		$321.76	$427.72	$804.40
Medica Facility/Professional Facility Modifier Low / Median / High Price $321.76 / $531.24 / $1,449.00	Facility		$321.76	$531.24	$1,449.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $321.76 / $427.72 / $804.40	Facility		$321.76	$427.72	$804.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $769.39 / $942.48 / $1,351.36	Professional		$769.39	$942.48	$1,351.36
Quartz Facility/Professional Facility Modifier Low / Median / High Price $264.92 / $264.92 / $1,631.92	Facility		$264.92	$264.92	$1,631.92
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $1,142.33 / $1,142.33 / $1,142.33	Facility	54	$1,142.33	$1,142.33	$1,142.33
United Facility/Professional Facility Modifier Low / Median / High Price $1,008.00 / $1,370.00 / $2,202.90	Facility		$1,008.00	$1,370.00	$2,202.90