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 / $397.28	Professional		$318.75	$318.75	$397.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,338.15 / $1,338.15 / $1,338.15	Professional		$1,338.15	$1,338.15	$1,338.15
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 $1,438.18 / $1,438.18 / $1,438.18	Professional		$1,438.18	$1,438.18	$1,438.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $70.00 / $619.67	Professional		$55.00	$70.00	$619.67
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 $975.64 / $975.64 / $975.64	Facility		$975.64	$975.64	$975.64
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,338.15 / $1,338.15 / $1,338.15	Professional		$1,338.15	$1,338.15	$1,338.15