Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,536.65 / $15,412.20 / $19,599.30	Facility		$2,536.65	$15,412.20	$19,599.30
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $381.35 / $711.66 / $1,268.33	Facility	52	$381.35	$711.66	$1,268.33
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $7,084.00 / $11,791.00 / $18,603.00	Facility		$7,084.00	$11,791.00	$18,603.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $687.11 / $858.89 / $1,055.03	Facility		$687.11	$858.89	$1,055.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,785.12 / $2,086.05 / $3,200.06	Facility		$1,785.12	$2,086.05	$3,200.06
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $645.72 / $645.72 / $645.72	Facility	52	$645.72	$645.72	$645.72
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $80.72 / $80.72 / $80.72	Facility	AS	$80.72	$80.72	$80.72
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $695.84 / $942.77 / $2,099.08	Facility		$695.84	$942.77	$2,099.08
Medica Facility/Professional Facility Modifier Low / Median / High Price $695.84 / $1,177.11 / $13,744.20	Facility		$695.84	$1,177.11	$13,744.20
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $12,302.24 / $12,302.24 / $12,302.24	Facility	52	$12,302.24	$12,302.24	$12,302.24
Medica Facility/Professional Facility Modifier AS Low / Median / High Price $1,537.78 / $1,537.78 / $1,537.78	Facility	AS	$1,537.78	$1,537.78	$1,537.78
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $695.84 / $942.77 / $2,099.08	Facility		$695.84	$942.77	$2,099.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,308.59 / $1,745.24 / $2,874.17	Professional		$1,308.59	$1,745.24	$2,874.17
Quartz Facility/Professional Facility Modifier Low / Median / High Price $818.95 / $16,223.75 / $16,223.75	Facility		$818.95	$16,223.75	$16,223.75
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $645.72 / $12,302.24 / $12,302.24	Facility	52	$645.72	$12,302.24	$12,302.24
Quartz Facility/Professional Facility Modifier AS Low / Median / High Price $80.72 / $1,537.78 / $1,537.78	Facility	AS	$80.72	$1,537.78	$1,537.78
United Facility/Professional Facility Modifier Low / Median / High Price $6,154.00 / $12,373.00 / $15,903.00	Facility		$6,154.00	$12,373.00	$15,903.00