Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $17,782.79 / $39,810.72	Facility		$1,621.81	$17,782.79	$39,810.72
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $12,882.50 / $17,378.01 / $30,199.52	Facility		$12,882.50	$17,378.01	$30,199.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,715.35 / $4,365.16 / $6,918.31	Facility		$3,715.35	$4,365.16	$6,918.31
Cigna Facility/Professional Facility Modifier 22 Low / Median / High Price $3,162.28 / $3,162.28 / $3,162.28	Facility	22	$3,162.28	$3,162.28	$3,162.28
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $1,621.81 / $1,621.81 / $1,621.81	Facility	62	$1,621.81	$1,621.81	$1,621.81
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $263.03 / $263.03 / $263.03	Facility	AS	$263.03	$263.03	$263.03
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,479.11 / $1,995.26 / $8,912.51	Facility		$1,479.11	$1,995.26	$8,912.51
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,479.11 / $2,089.30 / $14,125.38	Facility		$1,479.11	$2,089.30	$14,125.38
Medica Facility/Professional Facility Modifier 62 Low / Median / High Price $13,182.57 / $13,182.57 / $13,182.57	Facility	62	$13,182.57	$13,182.57	$13,182.57
Medica Facility/Professional Facility Modifier AS Low / Median / High Price $2,089.30 / $2,089.30 / $2,089.30	Facility	AS	$2,089.30	$2,089.30	$2,089.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,862.09 / $3,311.31 / $5,248.07	Professional		$1,862.09	$3,311.31	$5,248.07
Quartz Facility/Professional Facility Modifier Low / Median / High Price $14,791.08 / $14,791.08 / $22,387.21	Facility		$14,791.08	$14,791.08	$22,387.21
Quartz Facility/Professional Facility Modifier 62 Low / Median / High Price $9,120.11 / $9,120.11 / $13,803.84	Facility	62	$9,120.11	$9,120.11	$13,803.84
Quartz Facility/Professional Facility Modifier AS Low / Median / High Price $1,479.11 / $1,479.11 / $2,238.72	Facility	AS	$1,479.11	$1,479.11	$2,238.72
United Facility/Professional Facility Modifier Low / Median / High Price $8,912.51 / $13,803.84 / $17,782.79	Facility		$8,912.51	$13,803.84	$17,782.79