Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.13 / $31.43 / $31.43	Facility	26	$22.13	$31.43	$31.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $82.40 / $105.76 / $214.16	Professional		$82.40	$105.76	$214.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.23 / $14.95 / $31.39	Professional	26	$13.23	$14.95	$31.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.91 / $192.82 / $571.55	Professional		$79.91	$192.82	$571.55
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.28 / $32.24 / $91.88	Professional	26	$14.28	$32.24	$91.88
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.65 / $46.33 / $61.58	Facility	26	$39.65	$46.33	$61.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.23 / $368.68 / $418.95	Professional		$87.23	$368.68	$418.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.62 / $52.92 / $60.14	Professional	26	$17.62	$52.92	$60.14
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $141.91 / $141.91 / $141.91	Facility	26	$141.91	$141.91	$141.91
Medica Facility/Professional Professional Modifier Low / Median / High Price $90.45 / $213.55 / $611.40	Professional		$90.45	$213.55	$611.40
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $16.85 / $38.96 / $163.46	Professional	26	$16.85	$38.96	$163.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $57.01 / $92.86 / $210.52	Professional		$57.01	$92.86	$210.52
Quartz Facility/Professional Professional Modifier Low / Median / High Price $200.20 / $257.41 / $349.76	Professional		$200.20	$257.41	$349.76
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $141.91 / $141.91	Facility	26	$100.00	$141.91	$141.91
Quartz Facility/Professional Professional Modifier Low / Median / High Price $155.28 / $442.22 / $611.40	Professional		$155.28	$442.22	$611.40
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $24.51 / $73.75 / $163.46	Professional	26	$24.51	$73.75	$163.46
Security Health Facility/Professional Professional Modifier Low / Median / High Price $148.88 / $552.41 / $644.37	Professional		$148.88	$552.41	$644.37
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.10 / $35.40 / $86.24	Professional	26	$30.10	$35.40	$86.24
United Facility/Professional Professional Modifier Low / Median / High Price $89.86 / $162.30 / $342.32	Professional		$89.86	$162.30	$342.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.12 / $35.54 / $64.72	Professional	26	$16.12	$35.54	$64.72