Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $215.29 / $712.54 / $14,482.00	Facility		$215.29	$712.54	$14,482.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $107.65 / $199.90 / $356.27	Facility	52	$107.65	$199.90	$356.27
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $43.06 / $79.95 / $142.51	Facility	53	$43.06	$79.95	$142.51
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,905.00 / $3,193.00 / $5,962.00	Facility		$1,905.00	$3,193.00	$5,962.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $503.73 / $588.64 / $902.99	Facility		$503.73	$588.64	$902.99
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $176.57 / $176.57 / $176.57	Facility	52	$176.57	$176.57	$176.57
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $44.14 / $44.14 / $44.14	Facility	53	$44.14	$44.14	$44.14
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $137.94 / $137.94 / $137.94	Facility	62	$137.94	$137.94	$137.94
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $22.07 / $22.07 / $22.07	Facility	AS	$22.07	$22.07	$22.07
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $195.43 / $273.74 / $745.50	Facility		$195.43	$273.74	$745.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $195.42 / $325.77 / $4,377.80	Facility		$195.42	$325.77	$4,377.80
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $3,716.72 / $3,716.72 / $3,716.72	Facility	52	$3,716.72	$3,716.72	$3,716.72
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $929.18 / $929.18 / $929.18	Facility	53	$929.18	$929.18	$929.18
Medica Facility/Professional Facility Modifier 62 Low / Median / High Price $2,903.69 / $2,903.69 / $2,903.69	Facility	62	$2,903.69	$2,903.69	$2,903.69
Medica Facility/Professional Facility Modifier AS Low / Median / High Price $464.59 / $464.59 / $464.59	Facility	AS	$464.59	$464.59	$464.59
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $195.43 / $273.74 / $760.20	Facility		$195.43	$273.74	$760.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $356.40 / $475.32 / $810.88	Professional		$356.40	$475.32	$810.88
Quartz Facility/Professional Facility Modifier Low / Median / High Price $225.67 / $4,901.45 / $4,901.45	Facility		$225.67	$4,901.45	$4,901.45
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $176.57 / $3,716.72 / $3,716.72	Facility	52	$176.57	$3,716.72	$3,716.72
Quartz Facility/Professional Facility Modifier 53 Low / Median / High Price $44.14 / $929.18 / $929.18	Facility	53	$44.14	$929.18	$929.18
Quartz Facility/Professional Facility Modifier 62 Low / Median / High Price $137.94 / $2,903.69 / $2,903.69	Facility	62	$137.94	$2,903.69	$2,903.69
Quartz Facility/Professional Facility Modifier AS Low / Median / High Price $22.07 / $464.59 / $464.59	Facility	AS	$22.07	$464.59	$464.59
United Facility/Professional Facility Modifier Low / Median / High Price $2,781.00 / $3,628.00 / $5,471.00	Facility		$2,781.00	$3,628.00	$5,471.00