Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Medica Facility/Professional Facility Modifier Low / Median / High Price $406.00 / $2,203.00 / $7,700.00	Facility		$406.00	$2,203.00	$7,700.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $70.00	Professional		$50.00	$58.40	$70.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5,900.00 / $5,900.00 / $5,900.00	Professional		$5,900.00	$5,900.00	$5,900.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $65.00 / $100.00	Facility		$65.00	$65.00	$100.00
United Facility/Professional Facility Modifier Low / Median / High Price $425.00 / $2,203.00 / $17,441.00	Facility		$425.00	$2,203.00	$17,441.00