Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,989.02 / $3,492.90 / $5,633.92	Facility		$2,989.02	$3,492.90	$5,633.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,167.66 / $2,736.53 / $5,717.75	Professional		$2,167.66	$2,736.53	$5,717.75
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,674.67 / $2,627.30 / $5,165.30	Facility		$1,674.67	$2,627.30	$5,165.30
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,673.60 / $2,520.00 / $5,165.30	Facility		$1,673.60	$2,520.00	$5,165.30
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,438.00 / $8,345.00 / $8,345.00	Professional		$2,438.00	$8,345.00	$8,345.00
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 $1,674.67 / $2,627.30 / $5,165.30	Facility		$1,674.67	$2,627.30	$5,165.30
Quartz Facility/Professional Facility Modifier Low / Median / High Price $5,062.97 / $5,062.97 / $5,062.97	Facility		$5,062.97	$5,062.97	$5,062.97
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4,169.60 / $8,345.00 / $8,345.00	Professional		$4,169.60	$8,345.00	$8,345.00