Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $206.72 / $206.72 / $206.72	Facility		$206.72	$206.72	$206.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $206.72 / $206.72 / $206.72	Professional		$206.72	$206.72	$206.72
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $206.72 / $206.72 / $206.72	Facility		$206.72	$206.72	$206.72
Medica Facility/Professional Facility Modifier Low / Median / High Price $206.72 / $206.72 / $206.72	Facility		$206.72	$206.72	$206.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $55.00 / $85.00	Professional		$50.00	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $206.72 / $206.72 / $206.72	Facility		$206.72	$206.72	$206.72