Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.76 / $47.76 / $47.76	Facility	26	$47.76	$47.76	$47.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.02 / $190.60 / $269.48	Professional		$46.02	$190.60	$269.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.07 / $37.06 / $50.50	Professional	26	$26.07	$37.06	$50.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $80.59 / $260.39 / $963.37	Professional		$80.59	$260.39	$963.37
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.81 / $62.54 / $189.01	Professional	26	$30.81	$62.54	$189.01
CareSource Facility/Professional Professional Modifier Low / Median / High Price $41.28 / $174.42 / $215.70	Professional		$41.28	$174.42	$215.70
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $84.71 / $98.98 / $151.85	Facility	26	$84.71	$98.98	$151.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $158.02 / $519.82 / $590.70	Professional		$158.02	$519.82	$590.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.27 / $91.63 / $104.13	Professional	26	$28.27	$91.63	$104.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $91.46 / $220.45 / $1,146.60	Professional		$91.46	$220.45	$1,146.60
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $34.53 / $73.22 / $196.77	Professional	26	$34.53	$73.22	$196.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.22 / $152.86 / $336.82	Professional		$58.22	$152.86	$336.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $194.74 / $418.85 / $603.00	Professional		$194.74	$418.85	$603.00
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $158.69 / $158.69 / $158.69	Facility	26	$158.69	$158.69	$158.69
Quartz Facility/Professional Professional Modifier Low / Median / High Price $158.02 / $775.04 / $1,146.60	Professional		$158.02	$775.04	$1,146.60
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $28.27 / $158.90 / $196.77	Professional	26	$28.27	$158.90	$196.77
United Facility/Professional Professional Modifier Low / Median / High Price $94.00 / $227.50 / $498.51	Professional		$94.00	$227.50	$498.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.53 / $72.45 / $139.72	Professional	26	$34.53	$72.45	$139.72