Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $932.43 / $1,493.66 / $14,482.00	Facility		$932.43	$1,493.66	$14,482.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $466.22 / $746.83 / $1,331.02	Facility	52	$466.22	$746.83	$1,331.02
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $186.49 / $298.73 / $532.41	Facility	53	$186.49	$298.73	$532.41
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $12,080.00 / $17,505.00 / $23,937.00	Facility		$12,080.00	$17,505.00	$23,937.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,869.82 / $2,185.04 / $3,524.39	Facility		$1,869.82	$2,185.04	$3,524.39
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $730.24 / $1,042.61 / $1,447.60	Facility		$730.24	$1,042.61	$1,447.60
Medica Facility/Professional Facility Modifier Low / Median / High Price $835.55 / $8,225.90 / $15,743.00	Facility		$835.55	$8,225.90	$15,743.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $730.24 / $1,042.61 / $1,447.60	Facility		$730.24	$1,042.61	$1,447.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,486.55 / $2,295.46 / $3,031.16	Professional		$1,486.55	$2,295.46	$3,031.16
Quartz Facility/Professional Facility Modifier Low / Median / High Price $9,664.93 / $9,664.93 / $9,664.93	Facility		$9,664.93	$9,664.93	$9,664.93
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $2,769.66 / $2,769.66 / $2,769.66	Facility	52	$2,769.66	$2,769.66	$2,769.66
Quartz Facility/Professional Facility Modifier 53 Low / Median / High Price $692.42 / $692.42 / $692.42	Facility	53	$692.42	$692.42	$692.42
Quartz Facility/Professional Facility Modifier 62 Low / Median / High Price $2,163.80 / $2,163.80 / $2,163.80	Facility	62	$2,163.80	$2,163.80	$2,163.80
United Facility/Professional Facility Modifier Low / Median / High Price $7,217.00 / $11,608.00 / $13,980.00	Facility		$7,217.00	$11,608.00	$13,980.00