Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $1,621.81 / $1,621.81	Professional		$1,621.81	$1,621.81	$1,621.81
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 $954.99 / $954.99 / $954.99	Facility		$954.99	$954.99	$954.99
Quartz Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $1,659.59 / $1,659.59	Professional		$954.99	$1,659.59	$1,659.59
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