Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $1,621.81 / $8,128.31	Facility		$1,288.25	$1,621.81	$8,128.31
Molina Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,348.96 / $5,011.87	Facility		$1,148.15	$1,348.96	$5,011.87
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