Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $2,137.96 / $14,454.40	Facility		$1,122.02	$2,137.96	$14,454.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,011.87 / $8,317.64 / $13,803.84	Facility		$5,011.87	$8,317.64	$13,803.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,630.27 / $3,090.30 / $4,897.79	Facility		$2,630.27	$3,090.30	$4,897.79
Cigna Facility/Professional Facility Modifier 22 Low / Median / High Price $2,187.76 / $2,187.76 / $2,187.76	Facility	22	$2,187.76	$2,187.76	$2,187.76
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $1,479.11 / $1,479.11 / $1,479.11	Facility	52	$1,479.11	$1,479.11	$1,479.11
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $181.97 / $181.97 / $181.97	Facility	AS	$181.97	$181.97	$181.97
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $1,380.38 / $7,244.36	Facility		$977.24	$1,380.38	$7,244.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $1,412.54 / $12,302.69	Facility		$1,023.29	$1,412.54	$12,302.69
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $3,890.45 / $3,890.45 / $3,890.45	Facility	52	$3,890.45	$3,890.45	$3,890.45
Medica Facility/Professional Facility Modifier AS Low / Median / High Price $489.78 / $489.78 / $489.78	Facility	AS	$489.78	$489.78	$489.78
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $2,398.83 / $3,715.35	Professional		$1,318.26	$2,398.83	$3,715.35
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,630.27 / $9,772.37 / $9,772.37	Facility		$2,630.27	$9,772.37	$9,772.37
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $2,137.96 / $2,137.96 / $7,762.47	Facility	52	$2,137.96	$2,137.96	$7,762.47
Quartz Facility/Professional Facility Modifier AS Low / Median / High Price $263.03 / $263.03 / $977.24	Facility	AS	$263.03	$263.03	$977.24
United Facility/Professional Facility Modifier Low / Median / High Price $7,585.78 / $12,302.69 / $16,982.44	Facility		$7,585.78	$12,302.69	$16,982.44