Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $200.00 / $200.00 / $1,083.15	Facility		$200.00	$200.00	$1,083.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.00 / $144.00 / $261.00	Professional		$144.00	$144.00	$261.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $49.16 / $70.00 / $88.92	Facility		$49.16	$70.00	$88.92
Medica Facility/Professional Facility Modifier Low / Median / High Price $41.75 / $74.62 / $225.13	Facility		$41.75	$74.62	$225.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $464.40 / $1,613.12 / $1,613.12	Professional		$464.40	$1,613.12	$1,613.12
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 $49.16 / $70.00 / $88.92	Facility		$49.16	$70.00	$88.92
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,613.12 / $1,613.12 / $1,613.12	Professional		$1,613.12	$1,613.12	$1,613.12