Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $570.57 / $1,197.47 / $14,482.00	Facility		$570.57	$1,197.47	$14,482.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $285.29 / $285.29 / $1,067.08	Facility	52	$285.29	$285.29	$1,067.08
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $427.93 / $427.93 / $1,600.62	Facility	54	$427.93	$427.93	$1,600.62
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 $1,521.99 / $1,778.57 / $2,728.37	Facility		$1,521.99	$1,778.57	$2,728.37
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $568.99 / $735.47 / $1,330.53	Facility		$568.99	$735.47	$1,330.53
Medica Facility/Professional Facility Modifier Low / Median / High Price $570.57 / $1,167.27 / $5,261.00	Facility		$570.57	$1,167.27	$5,261.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $568.99 / $735.47 / $1,330.53	Facility		$568.99	$735.47	$1,330.53
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,161.55 / $1,415.30 / $2,112.77	Professional		$1,161.55	$1,415.30	$2,112.77
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 52 Low / Median / High Price $3,605.48 / $3,605.48 / $3,605.48	Facility	52	$3,605.48	$3,605.48	$3,605.48
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 / $3,912.00 / $5,865.00	Facility		$2,723.00	$3,912.00	$5,865.00