Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Medica Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $295.12 / $295.12	Professional		$295.12	$295.12	$295.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $64.57 / $70.79	Professional		$50.12	$64.57	$70.79
Quartz Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $95.50 / $295.12	Facility		$95.50	$95.50	$295.12
Quartz Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $295.12 / $295.12	Professional		$95.50	$295.12	$295.12
United Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $81.28 / $151.36	Professional		$52.48	$81.28	$151.36