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 $1,328.38 / $1,328.38 / $1,328.38	Professional		$1,328.38	$1,328.38	$1,328.38
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 $1,047.49 / $1,047.49 / $1,047.49	Facility		$1,047.49	$1,047.49	$1,047.49