Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.84 / $45.84 / $45.84	Facility		$45.84	$45.84	$45.84
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.29 / $43.29 / $43.29	Facility	26	$43.29	$43.29	$43.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.84 / $49.95 / $77.50	Professional		$45.84	$49.95	$77.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.20 / $46.88 / $90.87	Professional	26	$19.20	$46.88	$90.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $59.33 / $187.04 / $282.07	Professional		$59.33	$187.04	$282.07
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.49 / $17.32 / $180.82	Professional	26	$7.49	$17.32	$180.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2.89 / $44.84 / $63.33	Facility		$2.89	$44.84	$63.33
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2.89 / $44.90 / $55.30	Professional		$2.89	$44.90	$55.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $131.56 / $153.74 / $235.84	Facility		$131.56	$153.74	$235.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $123.45 / $144.27 / $232.69	Facility	26	$123.45	$144.27	$232.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.45 / $67.97 / $158.16	Professional		$43.45	$67.97	$158.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.47 / $64.77 / $148.29	Professional	26	$40.47	$64.77	$148.29
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $41.78 / $55.30 / $138.24	Facility		$41.78	$55.30	$138.24
Medica Facility/Professional Facility Modifier Low / Median / High Price $41.78 / $58.98 / $141.63	Facility		$41.78	$58.98	$141.63
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $223.26 / $223.26 / $223.26	Facility	26	$223.26	$223.26	$223.26
Medica Facility/Professional Professional Modifier Low / Median / High Price $19.64 / $36.52 / $166.25	Professional		$19.64	$36.52	$166.25
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $19.85 / $36.50 / $157.02	Professional	26	$19.85	$36.50	$157.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.60 / $58.14 / $137.89	Professional		$21.60	$58.14	$137.89
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $41.78 / $55.30 / $138.24	Facility		$41.78	$55.30	$138.24
Quartz Facility/Professional Professional Modifier Low / Median / High Price $78.84 / $115.16 / $165.80	Professional		$78.84	$115.16	$165.80
Quartz Facility/Professional Facility Modifier Low / Median / High Price $95.06 / $242.00 / $242.00	Facility		$95.06	$242.00	$242.00
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $89.12 / $223.26 / $223.26	Facility	26	$89.12	$223.26	$223.26
Quartz Facility/Professional Professional Modifier Low / Median / High Price $43.45 / $213.89 / $302.45	Professional		$43.45	$213.89	$302.45
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $40.47 / $200.52 / $283.52	Professional	26	$40.47	$200.52	$283.52
Security Health Facility/Professional Professional Modifier Low / Median / High Price $137.84 / $255.31 / $255.31	Professional		$137.84	$255.31	$255.31
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.69 / $13.69 / $67.09	Professional	26	$13.69	$13.69	$67.09
United Facility/Professional Professional Modifier Low / Median / High Price $18.39 / $37.56 / $73.40	Professional		$18.39	$37.56	$73.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.13 / $39.81 / $70.95	Professional	26	$19.13	$39.81	$70.95