Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Medica Facility/Professional Facility Modifier Low / Median / High Price $3,981.07 / $4,897.79 / $10,471.29	Facility		$3,981.07	$4,897.79	$10,471.29
Molina Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $1,174.90 / $2,398.83	Facility		$1,174.90	$1,174.90	$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