Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,801.89 / $3,801.89 / $3,801.89	Facility		$3,801.89	$3,801.89	$3,801.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,801.89 / $3,801.89 / $3,801.89	Professional		$3,801.89	$3,801.89	$3,801.89
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $3,801.89 / $3,801.89 / $5,754.40	Facility		$3,801.89	$3,801.89	$5,754.40
Medica Facility/Professional Facility Modifier Low / Median / High Price $3,801.89 / $3,801.89 / $5,754.40	Facility		$3,801.89	$3,801.89	$5,754.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $60.26 / $70.79	Professional		$54.95	$60.26	$70.79
Quartz Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $64.57 / $2,691.53	Facility		$64.57	$64.57	$2,691.53