Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $137.38 / $157.97 / $190.08	Facility	26	$137.38	$157.97	$190.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.43 / $367.25 / $1,203.00	Professional		$173.43	$367.25	$1,203.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.76 / $138.66 / $658.35	Professional	26	$81.76	$138.66	$658.35
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $171.15 / $265.45 / $974.10	Professional		$171.15	$265.45	$974.10
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $88.63 / $147.32 / $516.64	Professional	26	$88.63	$147.32	$516.64
CareSource Facility/Professional Professional Modifier Low / Median / High Price $83.86 / $113.82 / $223.57	Professional		$83.86	$113.82	$223.57
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $239.70 / $280.11 / $429.69	Facility	26	$239.70	$280.11	$429.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $253.58 / $628.35 / $714.04	Professional		$253.58	$628.35	$714.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $114.53 / $319.95 / $363.59	Professional	26	$114.53	$319.95	$363.59
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $404.21 / $404.21 / $404.21	Facility	26	$404.21	$404.21	$404.21
Medica Facility/Professional Professional Modifier Low / Median / High Price $202.78 / $433.02 / $1,463.47	Professional		$202.78	$433.02	$1,463.47
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $102.30 / $216.04 / $605.95	Professional	26	$102.30	$216.04	$605.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $168.07 / $311.82	Professional		$65.00	$168.07	$311.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $321.52 / $419.64 / $759.79	Professional		$321.52	$419.64	$759.79
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $217.35 / $404.21 / $404.21	Facility	26	$217.35	$404.21	$404.21
Quartz Facility/Professional Professional Modifier Low / Median / High Price $264.64 / $866.35 / $1,463.47	Professional		$264.64	$866.35	$1,463.47
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $134.76 / $469.65 / $605.95	Professional	26	$134.76	$469.65	$605.95
Security Health Facility/Professional Professional Modifier Low / Median / High Price $525.24 / $1,119.61 / $1,119.61	Professional		$525.24	$1,119.61	$1,119.61
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $212.42 / $282.41 / $527.44	Professional	26	$212.42	$282.41	$527.44
United Facility/Professional Professional Modifier Low / Median / High Price $194.33 / $360.76 / $735.58	Professional		$194.33	$360.76	$735.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $99.12 / $181.64 / $401.89	Professional	26	$99.12	$181.64	$401.89