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 $266.10 / $318.75 / $318.75	Professional		$266.10	$318.75	$318.75
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 $1,271.50 / $1,271.50 / $1,271.50	Professional		$1,271.50	$1,271.50	$1,271.50
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 $1,012.87 / $1,012.87 / $1,012.87	Facility		$1,012.87	$1,012.87	$1,012.87
United Facility/Professional Facility Modifier Low / Median / High Price $385.04 / $385.04 / $385.04	Facility		$385.04	$385.04	$385.04