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 / $418.35	Professional		$318.75	$318.75	$418.35
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 $1,450.34 / $1,450.34 / $1,450.34	Professional		$1,450.34	$1,450.34	$1,450.34
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 $1,360.46 / $1,360.46 / $1,360.46	Facility		$1,360.46	$1,360.46	$1,360.46