Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $104.71 / $169.82	Facility		$89.13	$104.71	$169.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $63.10 / $79.43	Professional		$52.48	$63.10	$79.43
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $51.29 / $107.15	Facility		$33.11	$51.29	$107.15
Medica Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $66.07 / $114.82	Facility		$33.88	$66.07	$114.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $245.47 / $245.47	Professional		$245.47	$245.47	$245.47
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 $75.86 / $354.81 / $354.81	Facility		$75.86	$354.81	$354.81
Quartz Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $245.47 / $245.47	Professional		$95.50	$245.47	$245.47