Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,201.78 / $1,201.78 / $14,482.00	Facility		$1,201.78	$1,201.78	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,201.78 / $1,201.78 / $1,201.78	Professional		$1,201.78	$1,201.78	$1,201.78
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,201.78 / $1,201.78 / $1,507.37	Facility		$1,201.78	$1,201.78	$1,507.37
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,124.00 / $1,449.00 / $2,090.40	Facility		$1,124.00	$1,449.00	$2,090.40
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 $1,201.78 / $1,201.78 / $1,507.37	Facility		$1,201.78	$1,201.78	$1,507.37
United Facility/Professional Facility Modifier Low / Median / High Price $1,034.00 / $1,630.00 / $2,202.90	Facility		$1,034.00	$1,630.00	$2,202.90