Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $983.93 / $8,243.00 / $16,658.73	Facility		$983.93	$8,243.00	$16,658.73
Aetna Facility/Professional Facility Modifier AS Low / Median / High Price $667.80 / $667.80 / $667.80	Facility	AS	$667.80	$667.80	$667.80
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $10,878.00 / $14,586.00 / $21,869.00	Facility		$10,878.00	$14,586.00	$21,869.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $7,560.77 / $7,560.77 / $7,560.77	Facility		$7,560.77	$7,560.77	$7,560.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,603.34 / $3,042.20 / $4,666.82	Facility		$2,603.34	$3,042.20	$4,666.82
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $983.93 / $1,354.69 / $2,174.48	Facility		$983.93	$1,354.69	$2,174.48
Medica Facility/Professional Facility Modifier Low / Median / High Price $983.93 / $2,031.58 / $15,090.00	Facility		$983.93	$2,031.58	$15,090.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $983.93 / $1,354.69 / $2,174.48	Facility		$983.93	$1,354.69	$2,174.48
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,009.15 / $2,448.07 / $3,654.49	Professional		$2,009.15	$2,448.07	$3,654.49
Quartz Facility/Professional Facility Modifier Low / Median / High Price $7,213.88 / $7,213.88 / $19,913.50	Facility		$7,213.88	$7,213.88	$19,913.50
Quartz Facility/Professional Facility Modifier AS Low / Median / High Price $1,887.52 / $1,887.52 / $1,887.52	Facility	AS	$1,887.52	$1,887.52	$1,887.52
United Facility/Professional Facility Modifier Low / Median / High Price $5,729.00 / $12,447.00 / $17,450.00	Facility		$5,729.00	$12,447.00	$17,450.00