Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $137.47 / $1,613.95 / $6,066.97	Facility		$137.47	$1,613.95	$6,066.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $137.47 / $137.47 / $2,929.00	Professional		$137.47	$137.47	$2,929.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.00 / $165.00 / $1,296.11	Professional		$165.00	$165.00	$1,296.11
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $137.47 / $137.47 / $718.55	Facility		$137.47	$137.47	$718.55
Medica Facility/Professional Facility Modifier Low / Median / High Price $137.47 / $137.47 / $2,929.00	Facility		$137.47	$137.47	$2,929.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $54.63 / $54.63 / $54.63	Professional		$54.63	$54.63	$54.63
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 $137.47 / $137.47 / $718.55	Facility		$137.47	$137.47	$718.55
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 $165.00 / $165.00 / $165.00	Professional		$165.00	$165.00	$165.00