Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Medica Facility/Professional Professional Modifier Low / Median / High Price $4,265.80 / $4,265.80 / $4,265.80	Professional		$4,265.80	$4,265.80	$4,265.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $58.88 / $58.88	Professional		$58.88	$58.88	$58.88
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,511.89 / $2,511.89 / $2,511.89	Facility		$2,511.89	$2,511.89	$2,511.89
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,511.89 / $4,466.84 / $4,466.84	Professional		$2,511.89	$4,466.84	$4,466.84
United Facility/Professional Facility Modifier Low / Median / High Price $16,982.44 / $17,782.79 / $19,498.45	Facility		$16,982.44	$17,782.79	$19,498.45