Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $70.00 / $70.00 / $70.00	Facility		$70.00	$70.00	$70.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $70.00 / $70.00	Professional		$70.00	$70.00	$70.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $745.23 / $870.86 / $1,157.44	Facility		$745.23	$870.86	$1,157.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.00 / $102.00 / $387.66	Professional		$51.00	$102.00	$387.66
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $70.00 / $70.00 / $105.00	Facility		$70.00	$70.00	$105.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $70.00 / $70.00 / $105.00	Facility		$70.00	$70.00	$105.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $395.67	Professional		$50.00	$70.00	$395.67
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $70.00 / $70.00 / $105.00	Facility		$70.00	$70.00	$105.00
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 / $65.00 / $100.00	Facility		$65.00	$65.00	$100.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $51.00 / $51.00 / $51.00	Professional		$51.00	$51.00	$51.00