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 / $425.00	Professional		$318.75	$318.75	$425.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $620.00 / $2,221.19 / $2,221.19	Professional		$620.00	$2,221.19	$2,221.19
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 $1,490.62 / $1,490.62 / $1,490.62	Professional		$1,490.62	$1,490.62	$1,490.62
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 $1,040.19 / $1,040.19 / $1,040.19	Facility		$1,040.19	$1,040.19	$1,040.19
Quartz Facility/Professional Professional Modifier Low / Median / High Price $620.00 / $800.00 / $800.00	Professional		$620.00	$800.00	$800.00