Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $349.89 / $1,157.08 / $14,482.00	Facility		$349.89	$1,157.08	$14,482.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $174.95 / $324.62 / $578.54	Facility	52	$174.95	$324.62	$578.54
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $69.98 / $129.85 / $231.42	Facility	53	$69.98	$129.85	$231.42
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,169.00 / $7,344.00 / $10,382.04	Facility		$5,169.00	$7,344.00	$10,382.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $818.22 / $956.15 / $1,466.76	Facility		$818.22	$956.15	$1,466.76
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $283.33 / $283.33 / $283.33	Facility	52	$283.33	$283.33	$283.33
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $70.84 / $70.84 / $70.84	Facility	53	$70.84	$70.84	$70.84
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $313.80 / $445.74 / $865.65	Facility		$313.80	$445.74	$865.65
Medica Facility/Professional Facility Modifier Low / Median / High Price $310.94 / $489.85 / $7,318.00	Facility		$310.94	$489.85	$7,318.00
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $8,067.84 / $8,067.84 / $8,067.84	Facility	52	$8,067.84	$8,067.84	$8,067.84
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $2,016.96 / $2,016.96 / $2,016.96	Facility	53	$2,016.96	$2,016.96	$2,016.96
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $313.80 / $442.54 / $865.65	Facility		$313.80	$442.54	$865.65
Quartz Facility/Professional Professional Modifier Low / Median / High Price $570.60 / $760.99 / $1,319.07	Professional		$570.60	$760.99	$1,319.07
Quartz Facility/Professional Facility Modifier Low / Median / High Price $362.56 / $10,639.60 / $10,639.60	Facility		$362.56	$10,639.60	$10,639.60
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $283.33 / $8,067.84 / $8,067.84	Facility	52	$283.33	$8,067.84	$8,067.84
Quartz Facility/Professional Facility Modifier 53 Low / Median / High Price $70.84 / $2,016.96 / $2,016.96	Facility	53	$70.84	$2,016.96	$2,016.96
United Facility/Professional Facility Modifier Low / Median / High Price $4,103.00 / $6,754.00 / $8,384.00	Facility		$4,103.00	$6,754.00	$8,384.00