Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $6.00 / $6.00 / $6.00	Facility		$6.00	$6.00	$6.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $6.00 / $6.00 / $6.00	Professional		$6.00	$6.00	$6.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $15.01 / $22.55 / $30.00	Professional		$15.01	$22.55	$30.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.00 / $64.00 / $64.00	Facility		$64.00	$64.00	$64.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $11.70 / $11.70 / $11.70	Professional		$11.70	$11.70	$11.70
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $6.00 / $6.00 / $6.00	Facility		$6.00	$6.00	$6.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $6.00 / $6.00 / $8.40	Facility		$6.00	$6.00	$8.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $16.20 / $16.20 / $16.20	Professional		$16.20	$16.20	$16.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $70.00	Professional		$50.00	$58.40	$70.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $6.00 / $6.00 / $6.60	Facility		$6.00	$6.00	$6.60
Quartz Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $65.00 / $90.00	Facility		$65.00	$65.00	$90.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $11.70 / $16.20 / $16.20	Professional		$11.70	$16.20	$16.20