Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $272.37 / $898.44 / $27,476.89	Facility		$272.37	$898.44	$27,476.89
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $136.19 / $252.06 / $449.22	Facility	52	$136.19	$252.06	$449.22
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $54.47 / $100.82 / $179.69	Facility	53	$54.47	$100.82	$179.69
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,905.00 / $3,193.00 / $5,962.00	Facility		$1,905.00	$3,193.00	$5,962.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $633.49 / $740.28 / $1,135.60	Facility		$633.49	$740.28	$1,135.60
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $221.01 / $221.01 / $221.01	Facility	52	$221.01	$221.01	$221.01
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $55.25 / $55.25 / $55.25	Facility	53	$55.25	$55.25	$55.25
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $244.44 / $302.47 / $504.77	Facility		$244.44	$302.47	$504.77
Medica Facility/Professional Facility Modifier Low / Median / High Price $236.96 / $356.12 / $4,377.80	Facility		$236.96	$356.12	$4,377.80
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $2,722.36 / $2,722.36 / $2,722.36	Facility	52	$2,722.36	$2,722.36	$2,722.36
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $680.59 / $680.59 / $680.59	Facility	53	$680.59	$680.59	$680.59
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $236.96 / $305.67 / $512.00	Facility		$236.96	$305.67	$512.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $445.20 / $593.75 / $1,023.68	Professional		$445.20	$593.75	$1,023.68
Quartz Facility/Professional Facility Modifier Low / Median / High Price $283.45 / $3,590.15 / $3,590.15	Facility		$283.45	$3,590.15	$3,590.15
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $221.01 / $2,722.36 / $2,722.36	Facility	52	$221.01	$2,722.36	$2,722.36
Quartz Facility/Professional Facility Modifier 53 Low / Median / High Price $55.25 / $680.59 / $680.59	Facility	53	$55.25	$680.59	$680.59
United Facility/Professional Facility Modifier Low / Median / High Price $2,976.00 / $3,827.00 / $5,471.00	Facility		$2,976.00	$3,827.00	$5,471.00