Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.71 / $27.54 / $31.67	Facility	26	$24.71	$27.54	$31.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.39 / $110.21 / $494.18	Professional		$48.39	$110.21	$494.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.04 / $27.54 / $142.80	Professional	26	$12.04	$27.54	$142.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.92 / $113.78 / $369.46	Professional		$45.92	$113.78	$369.46
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $27.28 / $90.21	Professional	26	$11.48	$27.28	$90.21
CareSource Facility/Professional Professional Modifier Low / Median / High Price $13.12 / $39.15 / $61.58	Professional		$13.12	$39.15	$61.58
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.64 / $35.79 / $47.59	Facility	26	$30.64	$35.79	$47.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.52 / $164.69 / $187.15	Professional		$63.52	$164.69	$187.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.73 / $41.59 / $47.26	Professional	26	$13.73	$41.59	$47.26
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $80.00 / $80.00 / $80.00	Facility	26	$80.00	$80.00	$80.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $64.09 / $151.06 / $353.51	Professional		$64.09	$151.06	$353.51
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $14.66 / $33.11 / $74.64	Professional	26	$14.66	$33.11	$74.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.34 / $41.16 / $85.00	Professional		$19.34	$41.16	$85.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $88.40 / $132.44 / $199.14	Professional		$88.40	$132.44	$199.14
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $28.25 / $80.00 / $80.00	Facility	26	$28.25	$80.00	$80.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $69.36 / $292.70 / $353.51	Professional		$69.36	$292.70	$353.51
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $17.51 / $61.10 / $74.64	Professional	26	$17.51	$61.10	$74.64
Security Health Facility/Professional Professional Modifier Low / Median / High Price $275.75 / $293.45 / $353.52	Professional		$275.75	$293.45	$353.52
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $59.42 / $66.90 / $88.34	Professional	26	$59.42	$66.90	$88.34
United Facility/Professional Professional Modifier Low / Median / High Price $55.92 / $134.51 / $248.81	Professional		$55.92	$134.51	$248.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.94 / $65.88 / $94.03	Professional	26	$20.94	$65.88	$94.03