Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $425.00 / $425.00 / $425.00	Facility		$425.00	$425.00	$425.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $425.00 / $425.00	Professional		$250.00	$425.00	$425.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $425.00 / $425.00 / $600.00	Facility		$425.00	$425.00	$600.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $425.00 / $425.00 / $637.50	Facility		$425.00	$425.00	$637.50
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 $425.00 / $425.00 / $600.00	Facility		$425.00	$425.00	$600.00