Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $300.00 / $300.00 / $300.00	Professional		$300.00	$300.00	$300.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $300.00 / $300.00 / $300.00	Facility		$300.00	$300.00	$300.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $300.00 / $300.00	Facility		$100.00	$300.00	$300.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $85.00	Professional		$50.00	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $300.00 / $300.00 / $300.00	Facility		$300.00	$300.00	$300.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5,900.00 / $5,900.00 / $5,900.00	Professional		$5,900.00	$5,900.00	$5,900.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $65.00 / $100.00	Facility		$65.00	$65.00	$100.00