Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,925.80 / $3,925.80 / $3,925.80	Facility		$3,925.80	$3,925.80	$3,925.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,038.08 / $1,213.08 / $1,860.91	Facility		$1,038.08	$1,213.08	$1,860.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $783.13 / $2,845.30 / $3,233.30	Professional		$783.13	$2,845.30	$3,233.30
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,625.27 / $2,625.27 / $2,625.27	Professional		$2,625.27	$2,625.27	$2,625.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $55.00 / $70.00	Professional		$50.00	$55.00	$70.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $8,138.20 / $8,138.20 / $8,138.20	Facility		$8,138.20	$8,138.20	$8,138.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,455.97 / $2,625.27 / $2,625.27	Professional		$1,455.97	$2,625.27	$2,625.27