Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.88 / $21.88 / $31.62	Facility	26	$21.88	$21.88	$31.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $93.33 / $154.88	Professional		$63.10	$93.33	$154.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $14.13 / $30.90	Professional	26	$12.02	$14.13	$30.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $147.91 / $467.74	Professional		$79.43	$147.91	$467.74
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $21.88 / $77.62	Professional	26	$14.13	$21.88	$77.62
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.81 / $46.77 / $74.13	Facility	26	$39.81	$46.77	$74.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $218.78 / $426.58	Professional		$83.18	$218.78	$426.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $32.36 / $61.66	Professional	26	$15.85	$32.36	$61.66
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $223.87 / $295.12	Professional		$181.97	$223.87	$295.12
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $33.11 / $42.66	Professional	26	$27.54	$33.11	$42.66
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $141.25 / $141.25 / $141.25	Facility	26	$141.25	$141.25	$141.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $162.18 / $616.60	Professional		$83.18	$162.18	$616.60
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $31.62 / $162.18	Professional	26	$15.49	$31.62	$162.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $95.50	Professional		$32.36	$33.11	$95.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $257.04 / $331.13	Professional		$131.83	$257.04	$331.13
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $138.04 / $138.04	Facility	26	$100.00	$138.04	$138.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $426.58 / $616.60	Professional		$97.72	$426.58	$616.60
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $74.13 / $162.18	Professional	26	$18.62	$74.13	$162.18
Security Health Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $446.68 / $645.65	Professional		$147.91	$446.68	$645.65
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $35.48 / $67.61	Professional	26	$30.20	$35.48	$67.61
United Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $125.89 / $275.42	Professional		$83.18	$125.89	$275.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $22.91 / $51.29	Professional	26	$15.14	$22.91	$51.29