Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Cigna Facility/Professional Facility Modifier Low / Median / High Price $192.84 / $225.35 / $363.48	Facility		$192.84	$225.35	$363.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.03 / $188.98 / $214.75	Professional		$91.03	$188.98	$214.75
Medica Facility/Professional Facility Modifier Low / Median / High Price $280.72 / $280.72 / $280.72	Facility		$280.72	$280.72	$280.72
Medica Facility/Professional Professional Modifier Low / Median / High Price $280.72 / $280.72 / $280.72	Professional		$280.72	$280.72	$280.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.40 / $58.40 / $58.40	Professional		$58.40	$58.40	$58.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $141.69 / $141.69 / $156.13	Professional		$141.69	$141.69	$156.13
Quartz Facility/Professional Facility Modifier Low / Median / High Price $98.25 / $280.72 / $280.72	Facility		$98.25	$280.72	$280.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $210.54 / $280.72 / $280.72	Professional		$210.54	$280.72	$280.72