Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.44 / $83.18 / $100.00	Facility	26	$72.44	$83.18	$100.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $123.03 / $251.19	Professional		$89.13	$123.03	$251.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $50.12 / $123.03	Professional	26	$32.36	$50.12	$123.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $162.18 / $575.44	Professional		$104.71	$162.18	$575.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $67.61 / $223.87	Professional	26	$34.67	$67.61	$223.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $125.89 / $147.91 / $234.42	Facility	26	$125.89	$147.91	$234.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $239.88 / $436.52	Professional		$104.71	$239.88	$436.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $102.33 / $194.98	Professional	26	$39.81	$102.33	$194.98
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $234.42 / $316.23	Professional		$194.98	$234.42	$316.23
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $100.00 / $131.83	Professional	26	$87.10	$100.00	$131.83
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $218.78 / $218.78 / $218.78	Facility	26	$218.78	$218.78	$218.78
Medica Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $213.80 / $794.33	Professional		$109.65	$213.80	$794.33
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $74.13 / $309.03	Professional	26	$35.48	$74.13	$309.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $125.89	Professional		$32.36	$33.11	$125.89
Quartz Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $275.42 / $467.74	Professional		$141.25	$275.42	$467.74
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $112.20 / $309.03 / $309.03	Facility	26	$112.20	$309.03	$309.03
Quartz Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $616.60 / $794.33	Professional		$138.04	$616.60	$794.33
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $208.93 / $309.03	Professional	26	$53.70	$208.93	$309.03
Security Health Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $537.03 / $707.95	Professional		$245.47	$537.03	$707.95
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $75.86 / $186.21	Professional	26	$69.18	$75.86	$186.21
United Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $154.88 / $363.08	Professional		$104.71	$154.88	$363.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $57.54 / $120.23	Professional	26	$35.48	$57.54	$120.23