Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,040.38 / $3,552.92 / $5,730.74	Facility		$3,040.38	$3,552.92	$5,730.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,204.91 / $2,783.55 / $5,816.00	Professional		$2,204.91	$2,783.55	$5,816.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,745.88 / $3,091.02 / $4,935.00	Facility		$1,745.88	$3,091.02	$4,935.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,745.88 / $2,747.12 / $4,935.00	Facility		$1,745.88	$2,747.12	$4,935.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,715.00 / $15,682.00 / $15,682.00	Professional		$2,715.00	$15,682.00	$15,682.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.40 / $58.40 / $58.40	Professional		$58.40	$58.40	$58.40
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,745.88 / $3,091.02 / $4,935.00	Facility		$1,745.88	$3,091.02	$4,935.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $5,682.77 / $5,682.77 / $5,682.77	Facility		$5,682.77	$5,682.77	$5,682.77
Quartz Facility/Professional Professional Modifier Low / Median / High Price $6,380.25 / $15,682.00 / $15,682.00	Professional		$6,380.25	$15,682.00	$15,682.00