Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Medica Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $1,513.56 / $14,125.38	Facility		$630.96	$1,513.56	$14,125.38
Molina Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $5,011.87 / $5,011.87	Facility		$1,148.15	$5,011.87	$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