Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,768.95 / $3,768.95 / $3,768.95	Facility		$3,768.95	$3,768.95	$3,768.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,768.95 / $3,768.95 / $3,768.95	Professional		$3,768.95	$3,768.95	$3,768.95
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $3,768.95 / $3,768.95 / $6,784.11	Facility		$3,768.95	$3,768.95	$6,784.11
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,667.60 / $3,768.95 / $6,784.11	Facility		$2,667.60	$3,768.95	$6,784.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $60.00 / $85.00	Professional		$50.00	$60.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $3,768.95 / $3,768.95 / $6,784.11	Facility		$3,768.95	$3,768.95	$6,784.11
Quartz Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $65.00 / $2,667.60	Facility		$65.00	$65.00	$2,667.60