Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $5.00 / $5.00 / $5.00	Facility		$5.00	$5.00	$5.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $5.00 / $5.00 / $5.00	Professional		$5.00	$5.00	$5.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $14.33 / $14.33 / $14.33	Professional		$14.33	$14.33	$14.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $22.55 / $22.55 / $22.55	Facility		$22.55	$22.55	$22.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.17 / $19.17 / $23.23	Professional		$19.17	$19.17	$23.23
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $5.00 / $5.00 / $9.00	Facility		$5.00	$5.00	$9.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $5.00 / $5.00 / $90.00	Facility		$5.00	$5.00	$90.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $4.07 / $220.19 / $1,574.51	Professional		$4.07	$220.19	$1,574.51
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $85.00	Professional		$50.00	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $5.00 / $5.00 / $9.00	Facility		$5.00	$5.00	$9.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $22.55 / $22.55 / $90.00	Facility		$22.55	$22.55	$90.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $19.17 / $22.55 / $22.55	Professional		$19.17	$22.55	$22.55
Security Health Facility/Professional Professional Modifier Low / Median / High Price $20.50 / $23.64 / $24.12	Professional		$20.50	$23.64	$24.12