Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.00 / $40.00 / $40.00	Facility		$40.00	$40.00	$40.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $40.00 / $40.00	Professional		$40.00	$40.00	$40.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.00 / $82.36 / $218.00	Professional		$58.00	$82.36	$218.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,363.39 / $1,593.23 / $2,117.54	Facility		$1,363.39	$1,593.23	$2,117.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $139.72 / $279.44 / $634.69	Professional		$139.72	$279.44	$634.69
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $40.00 / $40.00 / $60.00	Facility		$40.00	$40.00	$60.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $40.00 / $40.00 / $72.00	Facility		$40.00	$40.00	$72.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $110.85 / $110.85 / $110.85	Professional		$110.85	$110.85	$110.85
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 $40.00 / $40.00 / $60.00	Facility		$40.00	$40.00	$60.00
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 / $80.00 / $381.85	Facility		$65.00	$80.00	$381.85
Quartz Facility/Professional Professional Modifier Low / Median / High Price $139.72 / $139.72 / $139.72	Professional		$139.72	$139.72	$139.72