Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Cigna Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $173.78 / $275.42	Facility		$147.91	$173.78	$275.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $104.71 / $131.83	Professional		$87.10	$104.71	$131.83
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $199.53 / $223.87	Facility		$69.18	$199.53	$223.87
Medica Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $199.53 / $223.87	Facility		$69.18	$199.53	$223.87
Medica Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $602.56 / $602.56	Professional		$602.56	$602.56	$602.56
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 $144.54 / $316.23 / $316.23	Facility		$144.54	$316.23	$316.23
Quartz Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $602.56 / $602.56	Professional		$269.15	$602.56	$602.56