Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $3,235.94 / $14,454.40	Facility		$1,737.80	$3,235.94	$14,454.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,011.87 / $8,128.31 / $13,803.84	Facility		$5,011.87	$8,128.31	$13,803.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,073.80 / $4,786.30 / $7,585.78	Facility		$4,073.80	$4,786.30	$7,585.78
Cigna Facility/Professional Facility Modifier 22 Low / Median / High Price $3,388.44 / $3,388.44 / $3,388.44	Facility	22	$3,388.44	$3,388.44	$3,388.44
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $2,238.72 / $2,238.72 / $2,238.72	Facility	52	$2,238.72	$2,238.72	$2,238.72
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $281.84 / $281.84 / $281.84	Facility	AS	$281.84	$281.84	$281.84
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $2,137.96 / $8,511.38	Facility		$1,513.56	$2,137.96	$8,511.38
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $2,187.76 / $5,888.44	Facility		$1,584.89	$2,187.76	$5,888.44
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $6,025.60 / $6,025.60 / $6,025.60	Facility	52	$6,025.60	$6,025.60	$6,025.60
Medica Facility/Professional Facility Modifier AS Low / Median / High Price $741.31 / $741.31 / $741.31	Facility	AS	$741.31	$741.31	$741.31
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,949.84 / $3,548.13 / $5,495.41	Professional		$1,949.84	$3,548.13	$5,495.41
Quartz Facility/Professional Facility Modifier Low / Median / High Price $4,073.80 / $14,791.08 / $14,791.08	Facility		$4,073.80	$14,791.08	$14,791.08
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $3,235.94 / $3,235.94 / $11,748.98	Facility	52	$3,235.94	$3,235.94	$11,748.98
Quartz Facility/Professional Facility Modifier AS Low / Median / High Price $407.38 / $407.38 / $1,479.11	Facility	AS	$407.38	$407.38	$1,479.11
United Facility/Professional Facility Modifier Low / Median / High Price $2,290.87 / $6,165.95 / $19,498.45	Facility		$2,290.87	$6,165.95	$19,498.45