Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4,998.68 / $4,998.68 / $4,998.68	Professional		$4,998.68	$4,998.68	$4,998.68
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $4,998.68 / $4,998.68 / $4,998.68	Facility		$4,998.68	$4,998.68	$4,998.68
Medica Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $4,998.68 / $4,998.68	Facility		$100.00	$4,998.68	$4,998.68
Medica Facility/Professional Professional Modifier Low / Median / High Price $888.93 / $888.93 / $1,155.60	Professional		$888.93	$888.93	$1,155.60
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 $4,998.68 / $4,998.68 / $4,998.68	Facility		$4,998.68	$4,998.68	$4,998.68
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
United Facility/Professional Professional Modifier Low / Median / High Price $888.93 / $888.93 / $1,066.72	Professional		$888.93	$888.93	$1,066.72