Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,612.40 / $8,466.00 / $40,201.42	Facility		$1,612.40	$8,466.00	$40,201.42
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $12,080.00 / $16,823.00 / $26,530.00	Facility		$12,080.00	$16,823.00	$26,530.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,745.05 / $4,376.39 / $6,713.50	Facility		$3,745.05	$4,376.39	$6,713.50
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $1,070.46 / $1,070.46 / $1,070.46	Facility	62	$1,070.46	$1,070.46	$1,070.46
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $171.27 / $171.27 / $171.27	Facility	AS	$171.27	$171.27	$171.27
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,462.56 / $1,842.19 / $3,168.00	Facility		$1,462.56	$1,842.19	$3,168.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,462.56 / $2,215.90 / $14,246.00	Facility		$1,462.56	$2,215.90	$14,246.00
Medica Facility/Professional Facility Modifier 62 Low / Median / High Price $13,156.44 / $13,156.44 / $13,156.44	Facility	62	$13,156.44	$13,156.44	$13,156.44
Medica Facility/Professional Facility Modifier AS Low / Median / High Price $2,105.03 / $2,105.03 / $2,105.03	Facility	AS	$2,105.03	$2,105.03	$2,105.03
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,462.56 / $1,844.81 / $3,168.00	Facility		$1,462.56	$1,844.81	$3,168.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,766.00 / $3,688.92 / $6,058.72	Professional		$2,766.00	$3,688.92	$6,058.72
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,749.72 / $22,189.40 / $22,189.40	Facility		$1,749.72	$22,189.40	$22,189.40
Quartz Facility/Professional Facility Modifier 62 Low / Median / High Price $1,070.46 / $13,156.44 / $13,156.44	Facility	62	$1,070.46	$13,156.44	$13,156.44
Quartz Facility/Professional Facility Modifier AS Low / Median / High Price $171.27 / $2,105.03 / $2,105.03	Facility	AS	$171.27	$2,105.03	$2,105.03
United Facility/Professional Facility Modifier Low / Median / High Price $8,627.00 / $12,373.00 / $15,903.00	Facility		$8,627.00	$12,373.00	$15,903.00