Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $318.75 / $318.75 / $2,572.88	Facility		$318.75	$318.75	$2,572.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $318.75 / $318.75	Professional		$250.00	$318.75	$318.75
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 $1,432.72 / $1,432.72 / $1,432.72	Professional		$1,432.72	$1,432.72	$1,432.72
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 $318.75 / $318.75 / $478.13	Facility		$318.75	$318.75	$478.13
Quartz Facility/Professional Facility Modifier Low / Median / High Price $933.74 / $933.74 / $933.74	Facility		$933.74	$933.74	$933.74