Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.14 / $84.42 / $318.16	Facility	26	$43.14	$84.42	$318.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.66 / $212.55 / $1,198.50	Professional		$106.66	$212.55	$1,198.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.25 / $70.41 / $382.94	Professional	26	$37.25	$70.41	$382.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $73.47 / $134.13 / $404.00	Professional	TC	$73.47	$134.13	$404.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $106.28 / $251.20 / $827.22	Professional		$106.28	$251.20	$827.22
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $39.21 / $93.23 / $305.64	Professional	26	$39.21	$93.23	$305.64
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $67.06 / $157.02 / $521.57	Professional	TC	$67.06	$157.02	$521.57
CareSource Facility/Professional Professional Modifier Low / Median / High Price $44.84 / $81.61 / $147.54	Professional		$44.84	$81.61	$147.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $105.43 / $123.20 / $163.75	Facility	26	$105.43	$123.20	$163.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $155.04 / $382.84 / $435.05	Professional		$155.04	$382.84	$435.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.44 / $140.91 / $160.13	Professional	26	$46.44	$140.91	$160.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $98.05 / $241.90 / $274.89	Professional	TC	$98.05	$241.90	$274.89
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $307.10 / $376.16 / $829.00	Facility	26	$307.10	$376.16	$829.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $133.82 / $335.90 / $1,267.82	Professional		$133.82	$335.90	$1,267.82
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $49.91 / $150.41 / $418.01	Professional	26	$49.91	$150.41	$418.01
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $83.58 / $226.36 / $1,108.00	Professional	TC	$83.58	$226.36	$1,108.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.20 / $80.11 / $190.23	Professional		$38.20	$80.11	$190.23
Quartz Facility/Professional Professional Modifier Low / Median / High Price $211.25 / $316.49 / $810.12	Professional		$211.25	$316.49	$810.12
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $376.16 / $376.16	Facility	26	$100.00	$376.16	$376.16
Quartz Facility/Professional Professional Modifier Low / Median / High Price $161.24 / $697.81 / $1,267.82	Professional		$161.24	$697.81	$1,267.82
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $59.35 / $209.35 / $315.37	Professional	26	$59.35	$209.35	$315.37
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $104.28 / $565.05 / $1,108.00	Professional	TC	$104.28	$565.05	$1,108.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $376.10 / $682.17 / $697.22	Professional		$376.10	$682.17	$697.22
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $141.05 / $163.86 / $228.85	Professional	26	$141.05	$163.86	$228.85
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $235.05 / $297.41 / $698.02	Professional	TC	$235.05	$297.41	$698.02
United Facility/Professional Professional Modifier Low / Median / High Price $129.83 / $294.58 / $658.83	Professional		$129.83	$294.58	$658.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.75 / $95.80 / $183.50	Professional	26	$45.75	$95.80	$183.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $79.92 / $174.12 / $414.54	Professional	TC	$79.92	$174.12	$414.54