Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,616.79 / $1,616.79 / $1,616.79	Professional		$1,616.79	$1,616.79	$1,616.79
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 Facility Modifier Low / Median / High Price $499.80 / $499.80 / $499.80	Facility		$499.80	$499.80	$499.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $946.87 / $946.87 / $1,616.79	Professional		$946.87	$946.87	$1,616.79