Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $199.53 / $199.53	Facility		$199.53	$199.53	$199.53
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $1,548.82 / $1,995.26	Facility		$1,258.93	$1,548.82	$1,995.26
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $1,023.29 / $1,023.29	Facility		$1,023.29	$1,023.29	$1,023.29
Medica Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $338.84 / $338.84	Professional		$338.84	$338.84	$338.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $50.12 / $70.79	Professional		$32.36	$50.12	$70.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $338.84 / $338.84	Professional		$338.84	$338.84	$338.84
United Facility/Professional Facility Modifier Low / Median / High Price $1,071.52 / $1,071.52 / $1,412.54	Facility		$1,071.52	$1,071.52	$1,412.54