Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.00 / $50.00 / $50.00	Facility		$50.00	$50.00	$50.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $50.00 / $50.00	Professional		$50.00	$50.00	$50.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.00 / $112.18 / $170.00	Professional		$79.00	$112.18	$170.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $50.00 / $50.00 / $75.00	Facility		$50.00	$50.00	$75.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $50.00 / $50.00 / $90.00	Facility		$50.00	$50.00	$90.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $139.60 / $139.60 / $139.60	Professional		$139.60	$139.60	$139.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $85.00	Professional		$50.00	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $50.00 / $50.00 / $75.00	Facility		$50.00	$50.00	$75.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5,900.00 / $5,900.00 / $5,900.00	Professional		$5,900.00	$5,900.00	$5,900.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $100.00 / $187.52	Facility		$65.00	$100.00	$187.52
Quartz Facility/Professional Professional Modifier Low / Median / High Price $139.60 / $139.60 / $139.60	Professional		$139.60	$139.60	$139.60