Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $5.89 / $125.89 / $125.89	Facility		$5.89	$125.89	$125.89
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.66 / $117.49 / $117.49	Facility	26	$42.66	$117.49	$117.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $46.77 / $57.54	Professional		$16.98	$46.77	$57.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $45.71 / $97.72	Professional	26	$22.91	$45.71	$97.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $141.25 / $281.84	Professional		$57.54	$141.25	$281.84
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $7.41 / $154.88	Professional	26	$7.41	$7.41	$154.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3.63 / $46.77 / $75.86	Facility		$3.63	$46.77	$75.86
CareSource Facility/Professional Professional Modifier Low / Median / High Price $3.09 / $45.71 / $100.00	Professional		$3.09	$45.71	$100.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $154.88 / $245.47	Facility		$131.83	$154.88	$245.47
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $123.03 / $144.54 / $229.09	Facility	26	$123.03	$144.54	$229.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $67.61 / $162.18	Professional		$43.65	$67.61	$162.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $63.10 / $151.36	Professional	26	$40.74	$63.10	$151.36
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $54.95 / $141.25	Facility		$41.69	$54.95	$141.25
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $131.83 / $147.91	Professional		$131.83	$131.83	$147.91
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $125.89 / $125.89 / $138.04	Professional	26	$125.89	$125.89	$138.04
Medica Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $58.88 / $141.25	Facility		$41.69	$58.88	$141.25
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $223.87 / $223.87 / $223.87	Facility	26	$223.87	$223.87	$223.87
Medica Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $33.11 / $302.00	Professional		$19.05	$33.11	$302.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $33.11 / $281.84	Professional	26	$19.05	$33.11	$281.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $33.11 / $70.79	Professional		$22.91	$33.11	$70.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $109.65 / $154.88	Professional		$74.13	$109.65	$154.88
Quartz Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $302.00 / $302.00	Facility		$93.33	$302.00	$302.00
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $87.10 / $281.84 / $281.84	Facility	26	$87.10	$281.84	$281.84
Quartz Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $208.93 / $302.00	Professional		$43.65	$208.93	$302.00
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $194.98 / $281.84	Professional	26	$40.74	$194.98	$281.84
Security Health Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $257.04 / $363.08	Professional		$138.04	$257.04	$363.08
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $44.67 / $67.61	Professional	26	$13.80	$44.67	$67.61
United Facility/Professional Facility Modifier Low / Median / High Price $2.34 / $2.34 / $2.34	Facility		$2.34	$2.34	$2.34
United Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $31.62 / $75.86	Professional		$18.20	$31.62	$75.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $31.62 / $75.86	Professional	26	$18.20	$31.62	$75.86