Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,374.09 / $2,954.03 / $14,482.00	Facility		$1,374.09	$2,954.03	$14,482.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $4,076.48 / $4,076.48 / $20,577.70	Facility	50	$4,076.48	$4,076.48	$20,577.70
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $687.05 / $1,477.02 / $2,632.37	Facility	52	$687.05	$1,477.02	$2,632.37
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $7,084.00 / $12,066.00 / $18,870.00	Facility		$7,084.00	$12,066.00	$18,870.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,729.74 / $4,358.49 / $7,030.09	Facility		$3,729.74	$4,358.49	$7,030.09
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,374.09 / $1,951.98 / $4,828.29	Facility		$1,374.09	$1,951.98	$4,828.29
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,374.09 / $4,614.00 / $8,384.00	Facility		$1,374.09	$4,614.00	$8,384.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,374.09 / $1,951.98 / $4,828.29	Facility		$1,374.09	$1,951.98	$4,828.29
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,843.75 / $4,391.18 / $6,142.98	Professional		$2,843.75	$4,391.18	$6,142.98
Quartz Facility/Professional Facility Modifier Low / Median / High Price $11,877.88 / $11,877.88 / $11,877.88	Facility		$11,877.88	$11,877.88	$11,877.88
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $5,298.36 / $5,298.36 / $5,298.36	Facility	52	$5,298.36	$5,298.36	$5,298.36
Quartz Facility/Professional Facility Modifier 62 Low / Median / High Price $4,139.34 / $4,139.34 / $4,139.34	Facility	62	$4,139.34	$4,139.34	$4,139.34
Quartz Facility/Professional Facility Modifier AS Low / Median / High Price $662.30 / $662.30 / $662.30	Facility	AS	$662.30	$662.30	$662.30
United Facility/Professional Facility Modifier Low / Median / High Price $4,918.00 / $6,477.00 / $8,384.00	Facility		$4,918.00	$6,477.00	$8,384.00