Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,300.00 / $1,300.00 / $1,300.00	Facility		$1,300.00	$1,300.00	$1,300.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,300.00 / $1,300.00	Professional		$1,000.00	$1,300.00	$1,300.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,615.94 / $2,972.67 / $4,689.43	Facility		$2,615.94	$2,972.67	$4,689.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,088.63 / $1,121.28 / $1,360.78	Professional		$1,088.63	$1,121.28	$1,360.78
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,300.00 / $1,300.00	Facility		$1,000.00	$1,300.00	$1,300.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,027.46 / $1,300.00	Facility		$1,000.00	$1,027.46	$1,300.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $55.00 / $85.00	Professional		$50.00	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,300.00 / $1,500.00	Facility		$1,000.00	$1,300.00	$1,500.00