Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Medica Facility/Professional Professional Modifier Low / Median / High Price $90.55 / $90.55 / $90.55	Professional		$90.55	$90.55	$90.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $70.00	Professional		$50.00	$58.40	$70.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $90.00 / $90.00 / $90.00	Facility		$90.00	$90.00	$90.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $52.96 / $52.96 / $90.55	Professional		$52.96	$52.96	$90.55