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 $20.00 / $20.00 / $30.00	Professional		$20.00	$20.00	$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 $9.01 / $9.01 / $9.01	Professional		$9.01	$9.01	$9.01
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $5.00 / $5.00 / $5.00	Facility		$5.00	$5.00	$5.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $5.00 / $5.00 / $7.00	Facility		$5.00	$5.00	$7.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $12.47 / $12.47 / $12.47	Professional		$12.47	$12.47	$12.47
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 $5.00 / $5.00 / $5.50	Facility		$5.00	$5.00	$5.50
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 $9.01 / $12.47 / $12.47	Professional		$9.01	$12.47	$12.47