Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $318.75 / $318.75 / $318.75	Facility		$318.75	$318.75	$318.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $318.75 / $318.75 / $425.63	Professional		$318.75	$318.75	$425.63
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $318.75 / $318.75 / $478.13	Facility		$318.75	$318.75	$478.13
Medica Facility/Professional Facility Modifier Low / Median / High Price $318.75 / $318.75 / $573.75	Facility		$318.75	$318.75	$573.75
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,274.91 / $1,274.91 / $1,274.91	Professional		$1,274.91	$1,274.91	$1,274.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $70.00 / $468.52	Professional		$55.00	$70.00	$468.52
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $318.75 / $318.75 / $478.13	Facility		$318.75	$318.75	$478.13
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,049.91 / $1,049.91 / $1,049.91	Facility		$1,049.91	$1,049.91	$1,049.91