Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.15 / $67.15 / $67.15	Facility		$67.15	$67.15	$67.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.15 / $67.15 / $122.24	Professional		$67.15	$67.15	$122.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $30.72 / $30.72 / $2,373.63	Facility		$30.72	$30.72	$2,373.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.72 / $869.25 / $1,086.56	Professional		$30.72	$869.25	$1,086.56
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $67.15 / $67.15 / $173.57	Facility		$67.15	$67.15	$173.57
Medica Facility/Professional Facility Modifier Low / Median / High Price $67.15 / $173.57 / $200.43	Facility		$67.15	$173.57	$200.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $55.00 / $65.00	Professional		$50.00	$55.00	$65.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $67.15 / $67.15 / $173.57	Facility		$67.15	$67.15	$173.57
Quartz Facility/Professional Facility Modifier Low / Median / High Price $30.72 / $65.00 / $200.43	Facility		$30.72	$65.00	$200.43
Quartz Facility/Professional Professional Modifier Low / Median / High Price $30.72 / $30.72 / $30.72	Professional		$30.72	$30.72	$30.72