Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $105.13 / $211.52 / $376.98	Facility	26	$105.13	$211.52	$376.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $318.13 / $416.94 / $1,569.00	Professional		$318.13	$416.94	$1,569.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.35 / $110.37 / $531.10	Professional	26	$97.35	$110.37	$531.10
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $186.01 / $320.01 / $839.80	Professional	52	$186.01	$320.01	$839.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $221.60 / $274.20 / $1,002.38	Professional	TC	$221.60	$274.20	$1,002.38
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $328.47 / $961.16 / $2,468.30	Professional		$328.47	$961.16	$2,468.30
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $103.35 / $276.14 / $711.70	Professional	26	$103.35	$276.14	$711.70
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $225.12 / $694.77 / $1,662.82	Professional	TC	$225.12	$694.77	$1,662.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $112.85 / $297.41 / $685.72	Professional		$112.85	$297.41	$685.72
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $264.93 / $309.58 / $499.36	Facility	26	$264.93	$309.58	$499.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $466.96 / $1,157.51 / $1,463.17	Professional		$466.96	$1,157.51	$1,463.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $154.09 / $321.72 / $424.43	Professional	26	$154.09	$321.72	$424.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $326.88 / $835.79 / $1,045.96	Professional	TC	$326.88	$835.79	$1,045.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $360.90 / $861.49 / $1,893.30	Professional		$360.90	$861.49	$1,893.30
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $119.56 / $283.91 / $618.37	Professional	26	$119.56	$283.91	$618.37
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $248.32 / $550.23 / $1,321.52	Professional	TC	$248.32	$550.23	$1,321.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $83.17 / $246.81 / $707.23	Professional		$83.17	$246.81	$707.23
Quartz Facility/Professional Professional Modifier Low / Median / High Price $660.40 / $1,016.00 / $1,287.73	Professional		$660.40	$1,016.00	$1,287.73
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $463.23 / $463.23 / $463.23	Facility	26	$463.23	$463.23	$463.23
Quartz Facility/Professional Professional Modifier Low / Median / High Price $515.83 / $1,709.25 / $2,698.08	Professional		$515.83	$1,709.25	$2,698.08
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $143.37 / $516.20 / $770.56	Professional	26	$143.37	$516.20	$770.56
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $372.46 / $1,193.05 / $1,927.52	Professional	TC	$372.46	$1,193.05	$1,927.52
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,545.35 / $2,188.71 / $2,188.71	Professional		$1,545.35	$2,188.71	$2,188.71
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $478.33 / $502.24 / $562.74	Professional	26	$478.33	$502.24	$562.74
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $934.99 / $1,043.09 / $1,099.99	Professional	TC	$934.99	$1,043.09	$1,099.99
United Facility/Professional Professional Modifier Low / Median / High Price $364.75 / $957.62 / $1,706.00	Professional		$364.75	$957.62	$1,706.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $119.56 / $307.76 / $501.14	Professional	26	$119.56	$307.76	$501.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $248.32 / $656.18 / $1,190.78	Professional	TC	$248.32	$656.18	$1,190.78