Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.79 / $56.34 / $296.10	Facility	26	$28.79	$56.34	$296.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.50 / $122.74 / $301.75	Professional		$48.50	$122.74	$301.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.05 / $89.41 / $238.00	Professional	26	$28.05	$89.41	$238.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.21 / $117.93 / $207.23	Professional		$45.21	$117.93	$207.23
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.50 / $69.31 / $124.57	Professional	26	$27.50	$69.31	$124.57
CareSource Facility/Professional Professional Modifier Low / Median / High Price $21.66 / $42.90 / $106.12	Professional		$21.66	$42.90	$106.12
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $71.19 / $83.19 / $134.18	Facility	26	$71.19	$83.19	$134.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $76.90 / $142.35 / $190.58	Professional		$76.90	$142.35	$190.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.39 / $81.51 / $107.54	Professional	26	$43.39	$81.51	$107.54
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $253.28 / $253.28 / $253.28	Facility	26	$253.28	$253.28	$253.28
Medica Facility/Professional Professional Modifier Low / Median / High Price $53.44 / $113.45 / $231.19	Professional		$53.44	$113.45	$231.19
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $32.84 / $81.58 / $210.00	Professional	26	$32.84	$81.58	$210.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.80 / $65.14 / $139.59	Professional		$26.80	$65.14	$139.59
Quartz Facility/Professional Professional Modifier Low / Median / High Price $96.20 / $133.02 / $168.07	Professional		$96.20	$133.02	$168.07
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $131.69 / $131.69 / $131.69	Facility	26	$131.69	$131.69	$131.69
Quartz Facility/Professional Professional Modifier Low / Median / High Price $69.73 / $225.90 / $358.08	Professional		$69.73	$225.90	$358.08
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $39.94 / $136.30 / $210.00	Professional	26	$39.94	$136.30	$210.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $92.57 / $150.03 / $170.53	Professional		$92.57	$150.03	$170.53
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $56.92 / $111.29 / $142.11	Professional	26	$56.92	$111.29	$142.11
United Facility/Professional Professional Modifier Low / Median / High Price $53.44 / $134.36 / $198.00	Professional		$53.44	$134.36	$198.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.72 / $72.31 / $119.47	Professional	26	$32.72	$72.31	$119.47