Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $8,511.38 / $15,848.93 / $23,442.29	Facility		$8,511.38	$15,848.93	$23,442.29
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $9,120.11 / $12,882.50 / $20,892.96	Facility		$9,120.11	$12,882.50	$20,892.96
CareSource Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $954.99 / $1,258.93	Facility		$776.25	$954.99	$1,258.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $2,089.30 / $3,311.31	Facility		$1,778.28	$2,089.30	$3,311.31
Cigna Facility/Professional Facility Modifier 22 Low / Median / High Price $1,479.11 / $1,479.11 / $1,479.11	Facility	22	$1,479.11	$1,479.11	$1,479.11
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $977.24 / $977.24 / $977.24	Facility	52	$977.24	$977.24	$977.24
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $123.03 / $123.03 / $123.03	Facility	AS	$123.03	$123.03	$123.03
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $954.99 / $8,128.31	Facility		$660.69	$954.99	$8,128.31
Medica Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $1,174.90 / $14,125.38	Facility		$691.83	$1,174.90	$14,125.38
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $12,302.69 / $12,302.69 / $12,302.69	Facility	52	$12,302.69	$12,302.69	$12,302.69
Medica Facility/Professional Facility Modifier AS Low / Median / High Price $1,548.82 / $1,548.82 / $1,548.82	Facility	AS	$1,548.82	$1,548.82	$1,548.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,621.81 / $2,511.89	Professional		$891.25	$1,621.81	$2,511.89
Quartz Facility/Professional Facility Modifier Low / Median / High Price $10,964.78 / $16,218.10 / $16,218.10	Facility		$10,964.78	$16,218.10	$16,218.10
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $8,709.64 / $8,709.64 / $12,882.50	Facility	52	$8,709.64	$8,709.64	$12,882.50
Quartz Facility/Professional Facility Modifier AS Low / Median / High Price $1,096.48 / $1,096.48 / $1,621.81	Facility	AS	$1,096.48	$1,096.48	$1,621.81
United Facility/Professional Facility Modifier Low / Median / High Price $8,912.51 / $13,803.84 / $17,378.01	Facility		$8,912.51	$13,803.84	$17,378.01