Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Facility		$30.00	$30.00	$30.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $10.00 / $14.20	Professional		$10.00	$10.00	$14.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.32 / $19.32 / $19.32	Professional		$19.32	$19.32	$19.32
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $30.00 / $30.00 / $54.00	Facility		$30.00	$30.00	$54.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $30.00 / $45.00 / $90.00	Facility		$30.00	$45.00	$90.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $188.65 / $188.65 / $188.65	Professional		$188.65	$188.65	$188.65
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 $30.00 / $30.00 / $54.00	Facility		$30.00	$30.00	$54.00
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 $19.32 / $19.32 / $19.32	Professional		$19.32	$19.32	$19.32
United Facility/Professional Professional Modifier Low / Median / High Price $188.65 / $188.65 / $188.65	Professional		$188.65	$188.65	$188.65