Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Cigna Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $575.44 / $912.01	Facility		$489.78	$575.44	$912.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $380.19 / $660.69	Professional		$309.03	$380.19	$660.69
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $436.52 / $1,071.52	Facility		$275.42	$436.52	$1,071.52
Medica Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $436.52 / $1,071.52	Facility		$275.42	$436.52	$1,071.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $2,137.96 / $2,137.96	Professional		$416.87	$2,137.96	$2,137.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $58.88 / $58.88	Professional		$58.88	$58.88	$58.88
Quartz Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $1,288.25 / $1,288.25	Facility		$549.54	$1,288.25	$1,288.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $2,137.96 / $2,137.96	Professional		$812.83	$2,137.96	$2,137.96