Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $23.99 / $23.99	Facility	26	$20.89	$23.99	$23.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $95.50 / $263.03	Professional		$70.79	$95.50	$263.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $30.90 / $83.18	Professional	26	$18.20	$30.90	$83.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $125.89 / $281.84	Professional		$75.86	$125.89	$281.84
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $32.36 / $72.44	Professional	26	$19.95	$32.36	$72.44
CareSource Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $50.12 / $89.13	Professional		$18.20	$50.12	$89.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.12 / $58.88 / $93.33	Facility	26	$50.12	$58.88	$93.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $199.53 / $275.42	Professional		$79.43	$199.53	$275.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $50.12 / $69.18	Professional	26	$23.44	$50.12	$69.18
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $162.18 / $208.93	Professional		$134.90	$162.18	$208.93
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $44.67 / $53.70	Professional	26	$34.67	$44.67	$53.70
Medica Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $107.15 / $512.86	Professional		$44.67	$107.15	$512.86
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $30.90 / $123.03	Professional	26	$19.95	$30.90	$123.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $85.11	Professional		$32.36	$33.11	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $190.55 / $263.03	Professional		$60.26	$190.55	$263.03
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $44.67 / $44.67 / $123.03	Facility	26	$44.67	$44.67	$123.03
Quartz Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $380.19 / $512.86	Professional		$89.13	$380.19	$512.86
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $97.72 / $123.03	Professional	26	$22.91	$97.72	$123.03
Security Health Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $389.05 / $489.78	Professional		$134.90	$389.05	$489.78
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $50.12 / $63.10	Professional	26	$33.11	$50.12	$63.10
United Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $100.00 / $245.47	Professional		$46.77	$100.00	$245.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $28.18 / $64.57	Professional	26	$19.50	$28.18	$64.57