Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $316.23 / $549.54	Facility		$75.86	$316.23	$549.54
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.15 / $43.65 / $75.86	Facility	26	$37.15	$43.65	$75.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $87.10 / $457.09	Professional		$54.95	$87.10	$457.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $58.88 / $204.17	Professional	26	$30.90	$58.88	$204.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $34.67 / $169.82	Professional	TC	$25.12	$34.67	$169.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $123.03 / $467.74	Professional		$66.07	$123.03	$467.74
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $69.18 / $204.17	Professional	26	$37.15	$69.18	$204.17
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $52.48 / $234.42	Professional	TC	$28.84	$52.48	$234.42
CareSource Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $51.29 / $104.71	Facility		$31.62	$51.29	$104.71
CareSource Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $47.86 / $91.20	Professional		$30.90	$47.86	$91.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $199.53 / $316.23	Facility		$169.82	$199.53	$316.23
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $95.50 / $109.65 / $177.83	Facility	26	$95.50	$109.65	$177.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $208.93 / $288.40	Professional		$97.72	$208.93	$288.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $117.49 / $144.54	Professional	26	$54.95	$117.49	$144.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $91.20 / $138.04	Professional	TC	$41.69	$91.20	$138.04
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $117.49 / $3,162.28	Facility		$63.10	$117.49	$3,162.28
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $147.91 / $199.53	Professional		$112.20	$147.91	$199.53
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $83.18 / $112.20	Professional	26	$64.57	$83.18	$112.20
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $64.57 / $87.10	Professional	TC	$48.98	$64.57	$87.10
Medica Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $117.49 / $1,513.56	Facility		$63.10	$117.49	$1,513.56
Medica Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $269.15 / $1,318.26	Professional		$91.20	$269.15	$1,318.26
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $125.89 / $630.96	Professional	26	$52.48	$125.89	$630.96
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $144.54 / $870.96	Professional	TC	$39.81	$144.54	$870.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $165.96	Professional		$32.36	$33.11	$165.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $151.36 / $234.42	Professional		$87.10	$151.36	$234.42
Quartz Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $2,951.21 / $2,951.21	Facility		$165.96	$2,951.21	$2,951.21
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $323.59 / $323.59	Facility	26	$100.00	$323.59	$323.59
Quartz Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $870.96 / $1,318.26	Professional		$102.33	$870.96	$1,318.26
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $446.68 / $630.96	Professional	26	$58.88	$446.68	$630.96
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $691.83 / $870.96	Professional	TC	$44.67	$691.83	$870.96
Security Health Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $389.05 / $616.60	Professional		$331.13	$389.05	$616.60
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $173.78 / $199.53 / $316.23	Professional	26	$173.78	$199.53	$316.23
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $165.96 / $194.98	Professional	TC	$134.90	$165.96	$194.98
United Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $1,548.82 / $1,949.84	Facility		$977.24	$1,548.82	$1,949.84
United Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $213.80 / $380.19	Professional		$77.62	$213.80	$380.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $91.20 / $169.82	Professional	26	$44.67	$91.20	$169.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $97.72 / $213.80	Professional	TC	$33.11	$97.72	$213.80