Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $588.62 / $588.62 / $588.62	Facility		$588.62	$588.62	$588.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $588.62 / $588.62 / $1,646.03	Professional		$588.62	$588.62	$1,646.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $781.33 / $781.33 / $781.33	Professional		$781.33	$781.33	$781.33
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $588.62 / $588.62 / $900.59	Facility		$588.62	$588.62	$900.59
Medica Facility/Professional Facility Modifier Low / Median / High Price $588.62 / $588.62 / $1,646.03	Facility		$588.62	$588.62	$1,646.03
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 $588.62 / $588.62 / $1,059.52	Facility		$588.62	$588.62	$1,059.52
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
Quartz Facility/Professional Professional Modifier Low / Median / High Price $781.33 / $781.33 / $781.33	Professional		$781.33	$781.33	$781.33