Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $1,737.80 / $6,918.31	Facility		$1,258.93	$1,737.80	$6,918.31
Molina Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,348.96 / $2,398.83	Facility		$1,148.15	$1,348.96	$2,398.83
Quartz Facility/Professional Facility Modifier Low / Median / High Price $13,803.84 / $13,803.84 / $13,803.84	Facility		$13,803.84	$13,803.84	$13,803.84