Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2.22 / $2.22 / $2.22	Facility		$2.22	$2.22	$2.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2.22 / $2.22 / $60.63	Professional		$2.22	$2.22	$60.63
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $2.22 / $2.22 / $37.65	Facility		$2.22	$2.22	$37.65
Medica Facility/Professional Facility Modifier Low / Median / High Price $2.22 / $2.22 / $60.63	Facility		$2.22	$2.22	$60.63
Medica Facility/Professional Professional Modifier Low / Median / High Price $52.92 / $52.92 / $52.92	Professional		$52.92	$52.92	$52.92
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 $2.22 / $2.22 / $37.65	Facility		$2.22	$2.22	$37.65
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 $52.92 / $52.92 / $52.92	Professional		$52.92	$52.92	$52.92