Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Cigna Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $245.47 / $389.05	Facility		$208.93	$245.47	$389.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $147.91 / $186.21	Professional		$123.03	$147.91	$186.21
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $125.89 / $199.53	Facility		$75.86	$125.89	$199.53
Medica Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $128.82 / $302.00	Facility		$77.62	$128.82	$302.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $416.87 / $416.87	Professional		$416.87	$416.87	$416.87
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 $239.88 / $363.08 / $363.08	Facility		$239.88	$363.08	$363.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $416.87 / $416.87	Professional		$213.80	$416.87	$416.87