Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $318.75 / $318.75 / $3,747.84	Facility		$318.75	$318.75	$3,747.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $318.75 / $318.75 / $425.00	Professional		$318.75	$318.75	$425.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,471.54 / $1,471.54 / $1,471.54	Professional		$1,471.54	$1,471.54	$1,471.54
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 / $600.00	Facility		$318.75	$318.75	$600.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,681.60 / $1,681.60 / $1,681.60	Professional		$1,681.60	$1,681.60	$1,681.60
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 $1,023.01 / $1,023.01 / $1,023.01	Facility		$1,023.01	$1,023.01	$1,023.01
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,471.54 / $1,471.54 / $1,471.54	Professional		$1,471.54	$1,471.54	$1,471.54
United Facility/Professional Facility Modifier Low / Median / High Price $644.41 / $913.16 / $1,177.50	Facility		$644.41	$913.16	$1,177.50