Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $114.82 / $114.82 / $162.18	Facility	26	$114.82	$114.82	$162.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $177.83 / $354.81	Professional		$128.82	$177.83	$354.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $75.86 / $177.83	Professional	26	$57.54	$75.86	$177.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $263.03 / $794.33	Professional		$169.82	$263.03	$794.33
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $114.82 / $363.08	Professional	26	$74.13	$114.82	$363.08
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $204.17 / $234.42 / $380.19	Facility	26	$204.17	$234.42	$380.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $371.54 / $724.44	Professional		$177.83	$371.54	$724.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $177.83 / $309.03	Professional	26	$81.28	$177.83	$309.03
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $363.08 / $489.78	Professional		$316.23	$363.08	$489.78
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $138.04 / $158.49 / $213.80	Professional	26	$138.04	$158.49	$213.80
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $346.74 / $346.74 / $346.74	Facility	26	$346.74	$346.74	$346.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $302.00 / $1,122.02	Professional		$177.83	$302.00	$1,122.02
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $144.54 / $478.63	Professional	26	$79.43	$144.54	$478.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $223.87	Professional		$32.36	$33.11	$223.87
Quartz Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $416.87 / $630.96	Professional		$229.09	$416.87	$630.96
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $177.83 / $478.63 / $478.63	Facility	26	$177.83	$478.63	$478.63
Quartz Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $851.14 / $1,122.02	Professional		$165.96	$851.14	$1,122.02
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $389.05 / $478.63	Professional	26	$74.13	$389.05	$478.63
Security Health Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $616.60 / $1,096.48	Professional		$457.09	$616.60	$1,096.48
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $229.09 / $245.47 / $354.81	Professional	26	$229.09	$245.47	$354.81
United Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $229.09 / $575.44	Professional		$177.83	$229.09	$575.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $109.65 / $251.19	Professional	26	$79.43	$109.65	$251.19