Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $318.75 / $3,000.46 / $5,360.74	Facility		$318.75	$3,000.46	$5,360.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $318.75 / $318.75 / $400.04	Professional		$318.75	$318.75	$400.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,940.81 / $1,940.81 / $1,940.81	Professional		$1,940.81	$1,940.81	$1,940.81
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 / $1,831.17	Facility		$318.75	$318.75	$1,831.17
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,921.87 / $1,921.87 / $1,921.87	Professional		$1,921.87	$1,921.87	$1,921.87
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 $3,617.00 / $3,617.00 / $3,617.00	Facility		$3,617.00	$3,617.00	$3,617.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,940.81 / $1,940.81 / $1,940.81	Professional		$1,940.81	$1,940.81	$1,940.81