Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.90 / $38.90 / $75.86	Facility	26	$38.90	$38.90	$75.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $56.23 / $97.72	Professional		$34.67	$56.23	$97.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $23.99 / $38.90	Professional	26	$18.20	$23.99	$38.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $72.44 / $234.42	Professional		$39.81	$72.44	$234.42
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $33.88 / $100.00	Professional	26	$20.89	$33.88	$100.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.70 / $63.10 / $100.00	Facility	26	$53.70	$63.10	$100.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $138.04 / $173.78	Professional		$75.86	$138.04	$173.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $60.26 / $72.44	Professional	26	$31.62	$60.26	$72.44
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $112.20 / $141.25	Professional		$91.20	$112.20	$141.25
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $46.77 / $63.10	Professional	26	$37.15	$46.77	$63.10
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $47.86 / $97.72 / $97.72	Facility	26	$47.86	$97.72	$97.72
Medica Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $67.61 / $331.13	Professional		$42.66	$67.61	$331.13
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $39.81 / $128.82	Professional	26	$22.91	$39.81	$128.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $70.79	Professional		$32.36	$33.11	$70.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $117.49 / $165.96	Professional		$66.07	$117.49	$165.96
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $47.86 / $128.82 / $128.82	Facility	26	$47.86	$128.82	$128.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $218.78 / $331.13	Professional		$60.26	$218.78	$331.13
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $107.15 / $128.82	Professional	26	$30.90	$107.15	$128.82
Security Health Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $173.78 / $346.74	Professional		$112.20	$173.78	$346.74
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $89.13 / $109.65	Professional	26	$75.86	$89.13	$109.65
United Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $66.07 / $144.54	Professional		$41.69	$66.07	$144.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $33.88 / $72.44	Professional	26	$21.88	$33.88	$72.44