Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.22 / $104.22 / $104.22	Facility		$104.22	$104.22	$104.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.22 / $104.22 / $212.83	Professional		$104.22	$104.22	$212.83
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $104.22 / $104.22 / $304.11	Facility		$104.22	$104.22	$304.11
Medica Facility/Professional Facility Modifier Low / Median / High Price $104.22 / $104.22 / $416.37	Facility		$104.22	$104.22	$416.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $85.00	Professional		$50.00	$70.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $104.22 / $104.22 / $304.11	Facility		$104.22	$104.22	$304.11