Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,317.13 / $9,835.18 / $18,964.22	Facility		$1,317.13	$9,835.18	$18,964.22
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $6,474.96 / $6,474.96 / $6,474.96	Facility	22	$6,474.96	$6,474.96	$6,474.96
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $4,680.51 / $16,990.09 / $25,690.30	Facility	50	$4,680.51	$16,990.09	$25,690.30
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $7,084.00 / $11,838.00 / $18,458.00	Facility		$7,084.00	$11,838.00	$18,458.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $619.25 / $941.49 / $941.49	Facility		$619.25	$941.49	$941.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,664.37 / $1,944.95 / $3,137.13	Facility		$1,664.37	$1,944.95	$3,137.13
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $653.42 / $789.88 / $2,692.97	Facility		$653.42	$789.88	$2,692.97
Medica Facility/Professional Facility Modifier Low / Median / High Price $702.47 / $6,154.00 / $15,090.00	Facility		$702.47	$6,154.00	$15,090.00
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $2,443.05 / $6,554.00 / $13,253.76	Facility	50	$2,443.05	$6,554.00	$13,253.76
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $653.42 / $789.88 / $2,692.97	Facility		$653.42	$789.88	$2,692.97
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,277.25 / $1,965.00 / $2,323.21	Professional		$1,277.25	$1,965.00	$2,323.21
Quartz Facility/Professional Facility Modifier Low / Median / High Price $16,223.75 / $16,223.75 / $16,223.75	Facility		$16,223.75	$16,223.75	$16,223.75
Quartz 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
United Facility/Professional Facility Modifier Low / Median / High Price $7,984.00 / $12,373.00 / $15,090.00	Facility		$7,984.00	$12,373.00	$15,090.00