Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $43.91 / $144.12 / $14,482.00	Facility		$43.91	$144.12	$14,482.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $21.96 / $40.43 / $72.06	Facility	52	$21.96	$40.43	$72.06
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $8.77 / $16.17 / $28.82	Facility	53	$8.77	$16.17	$28.82
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,139.00 / $2,419.00 / $4,441.52	Facility		$1,139.00	$2,419.00	$4,441.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.93 / $117.94 / $180.92	Facility		$100.93	$117.94	$180.92
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $35.19 / $35.19 / $35.19	Facility	52	$35.19	$35.19	$35.19
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $8.80 / $8.80 / $8.80	Facility	53	$8.80	$8.80	$8.80
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $39.36 / $54.24 / $103.11	Facility		$39.36	$54.24	$103.11
Medica Facility/Professional Facility Modifier Low / Median / High Price $38.92 / $60.61 / $1,449.00	Facility		$38.92	$60.61	$1,449.00
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $910.60 / $910.60 / $910.60	Facility	52	$910.60	$910.60	$910.60
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $227.65 / $227.65 / $227.65	Facility	53	$227.65	$227.65	$227.65
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $38.79 / $54.23 / $103.11	Facility		$38.79	$54.23	$103.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $71.40 / $95.22 / $163.18	Professional		$71.40	$95.22	$163.18
Quartz Facility/Professional Facility Modifier Low / Median / High Price $45.46 / $1,300.00 / $1,300.00	Facility		$45.46	$1,300.00	$1,300.00
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $35.19 / $910.60 / $910.60	Facility	52	$35.19	$910.60	$910.60
Quartz Facility/Professional Facility Modifier 53 Low / Median / High Price $8.80 / $227.65 / $227.65	Facility	53	$8.80	$227.65	$227.65
United Facility/Professional Facility Modifier Low / Median / High Price $1,034.00 / $1,630.00 / $2,202.90	Facility		$1,034.00	$1,630.00	$2,202.90