Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,315.01 / $4,366.37 / $19,468.82	Facility		$1,315.01	$4,366.37	$19,468.82
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $657.51 / $1,224.98 / $2,183.19	Facility	52	$657.51	$1,224.98	$2,183.19
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 $3,070.12 / $3,587.67 / $5,503.58	Facility		$3,070.12	$3,587.67	$5,503.58
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $1,108.61 / $1,108.61 / $1,108.61	Facility	52	$1,108.61	$1,108.61	$1,108.61
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $138.58 / $138.58 / $138.58	Facility	AS	$138.58	$138.58	$138.58
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,191.47 / $1,560.63 / $2,680.25	Facility		$1,191.47	$1,560.63	$2,680.25
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,191.47 / $1,785.64 / $4,821.00	Facility		$1,191.47	$1,785.64	$4,821.00
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $4,525.71 / $4,525.71 / $4,525.71	Facility	52	$4,525.71	$4,525.71	$4,525.71
Medica Facility/Professional Facility Modifier AS Low / Median / High Price $565.71 / $565.71 / $565.71	Facility	AS	$565.71	$565.71	$565.71
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,191.47 / $1,587.54 / $2,624.17	Facility		$1,191.47	$1,587.54	$2,624.17
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,242.19 / $2,990.35 / $4,952.54	Professional		$2,242.19	$2,990.35	$4,952.54
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,411.74 / $11,453.28 / $11,453.28	Facility		$1,411.74	$11,453.28	$11,453.28
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $1,108.61 / $4,525.71 / $4,525.71	Facility	52	$1,108.61	$4,525.71	$4,525.71
Quartz Facility/Professional Facility Modifier AS Low / Median / High Price $138.58 / $565.71 / $565.71	Facility	AS	$138.58	$565.71	$565.71
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