Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,013.11 / $1,013.11 / $1,013.11	Facility		$1,013.11	$1,013.11	$1,013.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,045.88 / $3,742.71 / $5,304.72	Facility		$2,045.88	$3,742.71	$5,304.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $668.51 / $2,319.37 / $2,635.65	Professional		$668.51	$2,319.37	$2,635.65
Medica Facility/Professional Facility Modifier Low / Median / High Price $3,102.50 / $3,102.50 / $13,687.50	Facility		$3,102.50	$3,102.50	$13,687.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $10,037.50 / $10,037.50 / $10,037.50	Professional		$10,037.50	$10,037.50	$10,037.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.40 / $58.40 / $58.40	Professional		$58.40	$58.40	$58.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $656.14 / $1,228.36 / $3,132.00	Professional		$656.14	$1,228.36	$3,132.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $656.14 / $3,102.50 / $13,687.50	Facility		$656.14	$3,102.50	$13,687.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,257.63 / $10,037.50 / $10,037.50	Professional		$3,257.63	$10,037.50	$10,037.50