Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $554.47 / $1,576.21 / $17,823.00	Facility		$554.47	$1,576.21	$17,823.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $277.24 / $442.20 / $788.11	Facility	52	$277.24	$442.20	$788.11
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $110.89 / $176.88 / $315.24	Facility	53	$110.89	$176.88	$315.24
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,793.00 / $15,494.00 / $19,992.00	Facility		$6,793.00	$15,494.00	$19,992.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,105.67 / $1,292.07 / $2,084.06	Facility		$1,105.67	$1,292.07	$2,084.06
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $432.38 / $692.36 / $977.24	Facility		$432.38	$692.36	$977.24
Medica Facility/Professional Facility Modifier Low / Median / High Price $495.31 / $9,596.00 / $28,884.00	Facility		$495.31	$9,596.00	$28,884.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $432.38 / $692.36 / $977.24	Facility		$432.38	$692.36	$977.24
Quartz Facility/Professional Professional Modifier Low / Median / High Price $881.40 / $1,361.02 / $1,792.99	Professional		$881.40	$1,361.02	$1,792.99
Quartz Facility/Professional Facility Modifier Low / Median / High Price $54,852.40 / $54,852.40 / $54,852.40	Facility		$54,852.40	$54,852.40	$54,852.40
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $41,267.12 / $41,267.12 / $41,267.12	Facility	52	$41,267.12	$41,267.12	$41,267.12
Quartz Facility/Professional Facility Modifier 53 Low / Median / High Price $10,316.78 / $10,316.78 / $10,316.78	Facility	53	$10,316.78	$10,316.78	$10,316.78
United Facility/Professional Facility Modifier Low / Median / High Price $9,662.00 / $20,245.00 / $33,255.00	Facility		$9,662.00	$20,245.00	$33,255.00