Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
CareSource Facility/Professional Facility Modifier Low / Median / High Price $319.44 / $319.44 / $319.44	Facility		$319.44	$319.44	$319.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $350.54 / $409.63 / $628.38	Facility		$350.54	$409.63	$628.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.27 / $131.30 / $614.21	Professional		$53.27	$131.30	$614.21
Medica Facility/Professional Professional Modifier Low / Median / High Price $638.00 / $687.43 / $687.43	Professional		$638.00	$687.43	$687.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $70.00	Professional		$50.00	$58.40	$70.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $214.60 / $214.60 / $214.60	Facility		$214.60	$214.60	$214.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $71.06 / $638.00 / $687.43	Professional		$71.06	$638.00	$687.43