Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Cigna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $109.65 / $173.78	Facility		$93.33	$109.65	$173.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $66.07 / $83.18	Professional		$54.95	$66.07	$83.18
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $53.70 / $87.10	Facility		$31.62	$53.70	$87.10
Medica Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $57.54 / $234.42	Facility		$33.88	$57.54	$234.42
Medica Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $199.53 / $199.53	Professional		$199.53	$199.53	$199.53
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 $109.65 / $1,778.28 / $1,778.28	Facility		$109.65	$1,778.28	$1,778.28
Quartz Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $199.53 / $199.53	Professional		$85.11	$199.53	$199.53