Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,436.14 / $14,482.00 / $31,265.78	Facility		$2,436.14	$14,482.00	$31,265.78
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $639.89 / $1,218.07 / $2,170.88	Facility	52	$639.89	$1,218.07	$2,170.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $12,080.00 / $16,823.00 / $26,530.00	Facility		$12,080.00	$16,823.00	$26,530.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,129.24 / $1,708.64 / $1,708.64	Facility		$1,129.24	$1,708.64	$1,708.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,052.09 / $3,566.61 / $5,752.82	Facility		$3,052.09	$3,566.61	$5,752.82
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,279.77 / $1,966.05 / $9,016.58	Facility		$1,279.77	$1,966.05	$9,016.58
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,279.77 / $9,016.58 / $22,691.00	Facility		$1,279.77	$9,016.58	$22,691.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,279.77 / $1,966.05 / $9,016.58	Facility		$1,279.77	$1,966.05	$9,016.58
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,324.40 / $3,589.23 / $4,509.02	Professional		$2,324.40	$3,589.23	$4,509.02
Quartz Facility/Professional Facility Modifier Low / Median / High Price $22,189.40 / $22,189.40 / $22,189.40	Facility		$22,189.40	$22,189.40	$22,189.40
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $16,840.24 / $16,840.24 / $16,840.24	Facility	52	$16,840.24	$16,840.24	$16,840.24
Quartz Facility/Professional Facility Modifier 62 Low / Median / High Price $13,156.44 / $13,156.44 / $13,156.44	Facility	62	$13,156.44	$13,156.44	$13,156.44
Quartz Facility/Professional Facility Modifier AS Low / Median / High Price $2,105.03 / $2,105.03 / $2,105.03	Facility	AS	$2,105.03	$2,105.03	$2,105.03
United Facility/Professional Facility Modifier Low / Median / High Price $8,650.00 / $14,566.00 / $19,562.00	Facility		$8,650.00	$14,566.00	$19,562.00