Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $10,000.00 / $21,877.62	Facility		$630.96	$10,000.00	$21,877.62
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,011.87 / $8,317.64 / $13,182.57	Facility		$5,011.87	$8,317.64	$13,182.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,479.11 / $1,737.80 / $2,754.23	Facility		$1,479.11	$1,737.80	$2,754.23
Cigna Facility/Professional Facility Modifier 22 Low / Median / High Price $1,202.26 / $1,202.26 / $1,202.26	Facility	22	$1,202.26	$1,202.26	$1,202.26
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	AS	$100.00	$100.00	$100.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $794.33 / $5,248.07	Facility		$562.34	$794.33	$5,248.07
Medica Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $870.96 / $10,232.93	Facility		$562.34	$870.96	$10,232.93
Medica Facility/Professional Facility Modifier AS Low / Median / High Price $912.01 / $912.01 / $912.01	Facility	AS	$912.01	$912.01	$912.01
Quartz Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $1,348.96 / $2,089.30	Professional		$741.31	$1,348.96	$2,089.30
Quartz Facility/Professional Facility Modifier Low / Median / High Price $6,456.54 / $9,549.93 / $9,549.93	Facility		$6,456.54	$9,549.93	$9,549.93
Quartz Facility/Professional Facility Modifier AS Low / Median / High Price $645.65 / $645.65 / $954.99	Facility	AS	$645.65	$645.65	$954.99
United Facility/Professional Facility Modifier Low / Median / High Price $6,606.93 / $10,232.93 / $12,589.25	Facility		$6,606.93	$10,232.93	$12,589.25