Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $425.80 / $425.80 / $821.09	Facility	26	$425.80	$425.80	$821.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $839.60 / $1,180.74 / $3,161.44	Professional		$839.60	$1,180.74	$3,161.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $215.49 / $336.55 / $1,533.98	Professional	26	$215.49	$336.55	$1,533.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $843.65 / $1,751.73 / $5,889.49	Professional		$843.65	$1,751.73	$5,889.49
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $229.02 / $439.91 / $1,560.34	Professional	26	$229.02	$439.91	$1,560.34
CareSource Facility/Professional Professional Modifier Low / Median / High Price $340.70 / $1,131.24 / $1,748.57	Professional		$340.70	$1,131.24	$1,748.57
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $576.72 / $673.94 / $1,087.04	Facility	26	$576.72	$673.94	$1,087.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,437.63 / $2,533.37 / $3,683.69	Professional		$1,437.63	$2,533.37	$3,683.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $409.51 / $634.72 / $917.70	Professional	26	$409.51	$634.72	$917.70
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,020.19 / $1,826.49 / $4,916.24	Professional		$1,020.19	$1,826.49	$4,916.24
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $273.35 / $522.10 / $1,333.27	Professional	26	$273.35	$522.10	$1,333.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $234.35 / $730.75 / $1,860.14	Professional		$234.35	$730.75	$1,860.14
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,761.22 / $2,323.53 / $2,995.23	Professional		$1,761.22	$2,323.53	$2,995.23
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $2,151.76 / $2,151.76 / $2,151.76	Facility	26	$2,151.76	$2,151.76	$2,151.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,359.78 / $3,777.17 / $6,012.88	Professional		$1,359.78	$3,777.17	$6,012.88
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $340.68 / $946.35 / $1,456.11	Professional	26	$340.68	$946.35	$1,456.11
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,698.77 / $6,225.55 / $6,225.55	Professional		$3,698.77	$6,225.55	$6,225.55
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $514.79 / $1,183.16 / $1,302.05	Professional	26	$514.79	$1,183.16	$1,302.05
United Facility/Professional Professional Modifier Low / Median / High Price $1,020.19 / $1,836.46 / $4,612.85	Professional		$1,020.19	$1,836.46	$4,612.85
United Facility/Professional Professional Modifier 26 Low / Median / High Price $273.35 / $722.34 / $1,333.27	Professional	26	$273.35	$722.34	$1,333.27