Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Cigna Facility/Professional Facility Modifier Low / Median / High Price $490.21 / $572.85 / $923.98	Facility		$490.21	$572.85	$923.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $355.50 / $448.80 / $937.73	Professional		$355.50	$448.80	$937.73
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $275.45 / $630.00 / $1,064.68	Facility		$275.45	$630.00	$1,064.68
Medica Facility/Professional Facility Modifier Low / Median / High Price $275.45 / $630.00 / $1,064.68	Facility		$275.45	$630.00	$1,064.68
Medica Facility/Professional Professional Modifier Low / Median / High Price $419.00 / $2,154.00 / $2,154.00	Professional		$419.00	$2,154.00	$2,154.00
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 $275.45 / $630.00 / $1,064.68	Facility		$275.45	$630.00	$1,064.68
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,300.00 / $1,300.00 / $1,300.00	Facility		$1,300.00	$1,300.00	$1,300.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $814.50 / $2,154.00 / $2,154.00	Professional		$814.50	$2,154.00	$2,154.00