Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $409.67 / $872.44 / $14,482.00	Facility		$409.67	$872.44	$14,482.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $204.84 / $204.84 / $777.44	Facility	52	$204.84	$204.84	$777.44
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $307.25 / $307.25 / $1,166.16	Facility	54	$307.25	$307.25	$1,166.16
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 $1,106.58 / $1,293.11 / $1,983.68	Facility		$1,106.58	$1,293.11	$1,983.68
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $387.75 / $510.59 / $969.38	Facility		$387.75	$510.59	$969.38
Medica Facility/Professional Facility Modifier Low / Median / High Price $387.75 / $662.73 / $1,756.00	Facility		$387.75	$662.73	$1,756.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $387.75 / $510.59 / $969.38	Facility		$387.75	$510.59	$969.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $845.65 / $1,030.39 / $1,538.17	Professional		$845.65	$1,030.39	$1,538.17
Quartz Facility/Professional Facility Modifier Low / Median / High Price $264.92 / $264.92 / $2,000.00	Facility		$264.92	$264.92	$2,000.00
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $1,575.58 / $1,575.58 / $1,575.58	Facility	52	$1,575.58	$1,575.58	$1,575.58
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $1,378.64 / $1,378.64 / $1,378.64	Facility	54	$1,378.64	$1,378.64	$1,378.64
United Facility/Professional Facility Modifier Low / Median / High Price $1,034.00 / $1,423.00 / $2,202.90	Facility		$1,034.00	$1,423.00	$2,202.90