Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.00 / $75.00 / $75.00	Facility		$75.00	$75.00	$75.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $75.00 / $75.00	Professional		$75.00	$75.00	$75.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.00 / $68.16 / $187.00	Professional		$48.00	$68.16	$187.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $98.27 / $98.27 / $196.53	Professional		$98.27	$98.27	$196.53
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $75.00 / $75.00 / $112.50	Facility		$75.00	$75.00	$112.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $75.00 / $75.00 / $112.50	Facility		$75.00	$75.00	$112.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $188.44 / $188.44 / $188.44	Professional		$188.44	$188.44	$188.44
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 $75.00 / $75.00 / $112.50	Facility		$75.00	$75.00	$112.50
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 / $70.00 / $146.57	Facility		$65.00	$70.00	$146.57
Quartz Facility/Professional Professional Modifier Low / Median / High Price $98.27 / $98.27 / $98.27	Professional		$98.27	$98.27	$98.27