Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $0.85 / $2,400.03 / $14,482.00	Facility		$0.85	$2,400.03	$14,482.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $644.05 / $1,200.02 / $2,138.69	Facility	52	$644.05	$1,200.02	$2,138.69
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $257.62 / $480.01 / $855.48	Facility	53	$257.62	$480.01	$855.48
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,060.00 / $7,979.00 / $13,297.93	Facility		$5,060.00	$7,979.00	$13,297.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,002.53 / $3,508.70 / $5,382.43	Facility		$3,002.53	$3,508.70	$5,382.43
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $1,091.32 / $1,091.32 / $1,091.32	Facility	52	$1,091.32	$1,091.32	$1,091.32
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $272.83 / $272.83 / $272.83	Facility	53	$272.83	$272.83	$272.83
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $136.41 / $136.41 / $136.41	Facility	AS	$136.41	$136.41	$136.41
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,169.33 / $1,507.09 / $2,622.66	Facility		$1,169.33	$1,507.09	$2,622.66
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,169.33 / $1,727.00 / $4,821.00	Facility		$1,169.33	$1,727.00	$4,821.00
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $4,456.67 / $4,456.67 / $4,456.67	Facility	52	$4,456.67	$4,456.67	$4,456.67
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $1,114.17 / $1,114.17 / $1,114.17	Facility	53	$1,114.17	$1,114.17	$1,114.17
Medica Facility/Professional Facility Modifier AS Low / Median / High Price $557.08 / $557.08 / $557.08	Facility	AS	$557.08	$557.08	$557.08
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,169.33 / $1,504.53 / $2,579.01	Facility		$1,169.33	$1,504.53	$2,579.01
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,208.00 / $2,944.74 / $4,850.41	Professional		$2,208.00	$2,944.74	$4,850.41
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,391.39 / $11,255.12 / $11,255.12	Facility		$1,391.39	$11,255.12	$11,255.12
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $1,091.32 / $4,456.67 / $4,456.67	Facility	52	$1,091.32	$4,456.67	$4,456.67
Quartz Facility/Professional Facility Modifier 53 Low / Median / High Price $272.83 / $1,114.17 / $1,114.17	Facility	53	$272.83	$1,114.17	$1,114.17
Quartz Facility/Professional Facility Modifier AS Low / Median / High Price $136.41 / $557.08 / $557.08	Facility	AS	$136.41	$557.08	$557.08
United Facility/Professional Facility Modifier Low / Median / High Price $2,203.00 / $6,032.00 / $19,003.00	Facility		$2,203.00	$6,032.00	$19,003.00