Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $628.00 / $628.00 / $628.00	Professional		$628.00	$628.00	$628.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.45 / $70.93 / $80.20	Professional		$57.45	$70.93	$80.20
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $628.00 / $628.00 / $628.00	Facility		$628.00	$628.00	$628.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $628.00 / $628.00 / $967.12	Facility		$628.00	$628.00	$967.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $70.00	Professional		$50.00	$58.40	$70.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $628.00 / $628.00 / $628.00	Facility		$628.00	$628.00	$628.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $65.00 / $65.00	Facility		$65.00	$65.00	$65.00