Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Medica Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $89.13 / $89.13	Facility		$89.13	$89.13	$89.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $4.37 / $4.37 / $4.37	Professional		$4.37	$4.37	$4.37
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 $60.26 / $60.26 / $316.23	Facility		$60.26	$60.26	$316.23
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4.37 / $4.37 / $4.37	Professional		$4.37	$4.37	$4.37