Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $65.92 / $236.83 / $553.96	Facility		$65.92	$236.83	$553.96
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.64 / $75.53 / $134.62	Facility	26	$37.64	$75.53	$134.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.60 / $107.04 / $357.86	Professional		$62.60	$107.04	$357.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.15 / $68.84 / $204.00	Professional	26	$35.15	$68.84	$204.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.73 / $51.89 / $213.63	Professional	TC	$27.73	$51.89	$213.63
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.75 / $146.47 / $444.15	Professional		$64.75	$146.47	$444.15
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.79 / $78.59 / $223.46	Professional	26	$36.79	$78.59	$223.46
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.05 / $62.84 / $217.92	Professional	TC	$28.05	$62.84	$217.92
CareSource Facility/Professional Facility Modifier Low / Median / High Price $24.78 / $44.76 / $80.54	Facility		$24.78	$44.76	$80.54
CareSource Facility/Professional Professional Modifier Low / Median / High Price $29.45 / $44.16 / $80.54	Professional		$29.45	$44.16	$80.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $171.21 / $200.08 / $306.92	Facility		$171.21	$200.08	$306.92
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $94.62 / $110.57 / $169.61	Facility	26	$94.62	$110.57	$169.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $98.10 / $203.59 / $277.33	Professional		$98.10	$203.59	$277.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.42 / $114.82 / $140.99	Professional	26	$56.42	$114.82	$140.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $40.02 / $88.77 / $131.63	Professional	TC	$40.02	$88.77	$131.63
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $60.04 / $80.18 / $214.07	Facility		$60.04	$80.18	$214.07
Medica Facility/Professional Facility Modifier Low / Median / High Price $62.55 / $92.67 / $1,209.00	Facility		$62.55	$92.67	$1,209.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $95.70 / $277.52 / $1,317.18	Professional		$95.70	$277.52	$1,317.18
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $54.74 / $134.86 / $638.00	Professional	26	$54.74	$134.86	$638.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $40.40 / $139.04 / $870.88	Professional	TC	$40.40	$139.04	$870.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.36 / $61.88 / $147.46	Professional		$25.36	$61.88	$147.46
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $60.04 / $81.04 / $214.07	Facility		$60.04	$81.04	$214.07
Quartz Facility/Professional Professional Modifier Low / Median / High Price $96.69 / $151.44 / $218.04	Professional		$96.69	$151.44	$218.04
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,922.50 / $2,922.50 / $2,922.50	Facility		$2,922.50	$2,922.50	$2,922.50
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $323.94 / $323.94 / $323.94	Facility	26	$323.94	$323.94	$323.94
Quartz Facility/Professional Professional Modifier Low / Median / High Price $120.97 / $872.12 / $1,317.18	Professional		$120.97	$872.12	$1,317.18
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $68.68 / $347.34 / $638.00	Professional	26	$68.68	$347.34	$638.00
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $47.47 / $524.74 / $870.88	Professional	TC	$47.47	$524.74	$870.88
Security Health Facility/Professional Professional Modifier Low / Median / High Price $332.71 / $384.99 / $617.39	Professional		$332.71	$384.99	$617.39
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $174.73 / $201.28 / $367.49	Professional	26	$174.73	$201.28	$367.49
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $135.78 / $164.41 / $575.53	Professional	TC	$135.78	$164.41	$575.53
United Facility/Professional Facility Modifier Low / Median / High Price $785.00 / $1,370.00 / $2,202.90	Facility		$785.00	$1,370.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $81.58 / $234.77 / $415.77	Professional		$81.58	$234.77	$415.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.63 / $122.21 / $202.43	Professional	26	$49.63	$122.21	$202.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.97 / $100.47 / $227.72	Professional	TC	$36.97	$100.47	$227.72