Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $221.79 / $492.08 / $14,482.00	Facility		$221.79	$492.08	$14,482.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $246.61 / $295.93 / $384.74	Facility		$246.61	$295.93	$384.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $614.55 / $718.17 / $1,101.69	Facility		$614.55	$718.17	$1,101.69
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $221.79 / $300.74 / $477.41	Facility		$221.79	$300.74	$477.41
Medica Facility/Professional Facility Modifier Low / Median / High Price $221.79 / $350.56 / $1,789.00	Facility		$221.79	$350.56	$1,789.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $221.79 / $287.62 / $477.41	Facility		$221.79	$287.62	$477.41
Quartz Facility/Professional Professional Modifier Low / Median / High Price $466.20 / $612.90 / $882.36	Professional		$466.20	$612.90	$882.36
Quartz Facility/Professional Facility Modifier Low / Median / High Price $4,116.84 / $4,116.84 / $4,116.84	Facility		$4,116.84	$4,116.84	$4,116.84
Quartz Facility/Professional Facility Modifier 62 Low / Median / High Price $735.14 / $735.14 / $735.14	Facility	62	$735.14	$735.14	$735.14
Quartz Facility/Professional Facility Modifier AS Low / Median / High Price $117.62 / $117.62 / $117.62	Facility	AS	$117.62	$117.62	$117.62
United Facility/Professional Facility Modifier Low / Median / High Price $1,034.00 / $1,423.00 / $2,202.90	Facility		$1,034.00	$1,423.00	$2,202.90