Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4.00 / $4.00 / $4.00	Facility		$4.00	$4.00	$4.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4.00 / $4.00 / $4.00	Professional		$4.00	$4.00	$4.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1.30 / $1.30 / $202.50	Professional		$1.30	$1.30	$202.50
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 $4.93 / $4.93 / $4.93	Professional		$4.93	$4.93	$4.93
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $4.00 / $4.00 / $4.00	Facility		$4.00	$4.00	$4.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $4.00 / $4.00 / $5.60	Facility		$4.00	$4.00	$5.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $6.83 / $6.83 / $6.83	Professional		$6.83	$6.83	$6.83
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 $4.00 / $4.00 / $4.40	Facility		$4.00	$4.00	$4.40
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 $4.93 / $6.83 / $6.83	Professional		$4.93	$6.83	$6.83