Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $416.87 / $954.99	Facility		$199.53	$416.87	$954.99
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.81 / $46.77 / $81.28	Facility	26	$39.81	$46.77	$81.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $239.88 / $758.58	Professional		$162.18	$239.88	$758.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $60.26 / $213.80	Professional	26	$37.15	$60.26	$213.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $162.18 / $562.34	Professional	TC	$109.65	$162.18	$562.34
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $1,584.89 / $6,165.95	Facility		$1,202.26	$1,584.89	$6,165.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $371.54 / $870.96	Professional		$138.04	$371.54	$870.96
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $75.86 / $190.55	Professional	26	$39.81	$75.86	$190.55
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $295.12 / $645.65	Professional	TC	$97.72	$295.12	$645.65
CareSource Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $257.04 / $346.74	Professional		$89.13	$257.04	$346.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $602.56 / $954.99	Facility		$512.86	$602.56	$954.99
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $117.49 / $186.21	Facility	26	$100.00	$117.49	$186.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $616.60 / $691.83	Professional		$251.19	$616.60	$691.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $125.89 / $141.25	Professional	26	$58.88	$125.89	$141.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $489.78 / $549.54	Professional	TC	$194.98	$489.78	$549.54
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $2,454.71 / $4,786.30	Facility		$190.55	$2,454.71	$4,786.30
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $416.87 / $501.19	Professional		$302.00	$416.87	$501.19
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $97.72 / $120.23	Professional	26	$70.79	$97.72	$120.23
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $316.23 / $380.19	Professional	TC	$234.42	$316.23	$380.19
Medica Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $1,202.26 / $1,778.28	Facility		$186.21	$1,202.26	$1,778.28
Medica Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $316.23 / $1,548.82	Professional		$154.88	$316.23	$1,548.82
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $79.43 / $912.01	Professional	26	$41.69	$79.43	$912.01
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $229.09 / $1,122.02	Professional	TC	$102.33	$229.09	$1,122.02
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 $199.53 / $371.54 / $537.03	Professional		$199.53	$371.54	$537.03
Quartz Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $2,951.21 / $2,951.21	Facility		$436.52	$2,951.21	$2,951.21
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $102.33 / $245.47 / $245.47	Facility	26	$102.33	$245.47	$245.47
Quartz Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $912.01 / $1,584.89	Professional		$229.09	$912.01	$1,584.89
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $269.15 / $912.01	Professional	26	$53.70	$269.15	$912.01
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $630.96 / $1,148.15	Professional	TC	$173.78	$630.96	$1,148.15
Security Health Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $1,148.15 / $1,412.54	Professional		$588.84	$1,148.15	$1,412.54
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $186.21 / $234.42 / $275.42	Professional	26	$186.21	$234.42	$275.42
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $371.54 / $501.19 / $602.56	Professional	TC	$371.54	$501.19	$602.56
United Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $1,584.89 / $1,949.84	Facility		$1,023.29	$1,584.89	$1,949.84
United Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $251.19 / $691.83	Professional		$147.91	$251.19	$691.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $64.57 / $173.78	Professional	26	$39.81	$64.57	$173.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $199.53 / $512.86	Professional	TC	$100.00	$199.53	$512.86