Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Medica Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $338.84 / $338.84	Professional		$338.84	$338.84	$338.84
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 $109.65 / $109.65 / $338.84	Facility		$109.65	$109.65	$338.84
Quartz Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $338.84 / $338.84	Professional		$109.65	$338.84	$338.84
United Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $93.33 / $173.78	Professional		$60.26	$93.33	$173.78