Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $26.60 / $26.60 / $26.60	Facility		$26.60	$26.60	$26.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $177.72 / $212.83 / $247.90	Professional		$177.72	$212.83	$247.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $68.97 / $68.97 / $68.97	Facility		$68.97	$68.97	$68.97
Medica Facility/Professional Facility Modifier Low / Median / High Price $743.40 / $743.40 / $743.40	Facility		$743.40	$743.40	$743.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $14.00 / $14.00 / $14.00	Professional		$14.00	$14.00	$14.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $65.00 / $3,000.00	Professional		$55.00	$65.00	$3,000.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,960.00 / $1,960.00 / $1,960.00	Professional		$1,960.00	$1,960.00	$1,960.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,895.32 / $1,895.32 / $1,895.32	Facility		$1,895.32	$1,895.32	$1,895.32
Security Health Facility/Professional Professional Modifier Low / Median / High Price $54.59 / $54.59 / $54.59	Professional		$54.59	$54.59	$54.59
Security Health Facility/Professional Professional Modifier Low / Median / High Price $54.59 / $54.59 / $54.59	Professional		$54.59	$54.59	$54.59
United Facility/Professional Professional Modifier Low / Median / High Price $14.00 / $14.00 / $14.00	Professional		$14.00	$14.00	$14.00