Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.21 / $743.70 / $14,482.00	Facility		$63.21	$743.70	$14,482.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $350.54 / $409.63 / $628.38	Facility		$350.54	$409.63	$628.38
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $63.21 / $111.87 / $159.54	Facility		$63.21	$111.87	$159.54
Medica Facility/Professional Facility Modifier Low / Median / High Price $61.35 / $107.26 / $164.04	Facility		$61.35	$107.26	$164.04
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $63.21 / $113.11 / $159.54	Facility		$63.21	$113.11	$159.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $136.12 / $237.51 / $403.53	Professional		$136.12	$237.51	$403.53
Quartz Facility/Professional Facility Modifier Low / Median / High Price $93.73 / $361.79 / $361.79	Facility		$93.73	$361.79	$361.79