Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.71 / $104.71 / $112.20	Facility	26	$104.71	$104.71	$112.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $234.42 / $436.52	Professional		$147.91	$234.42	$436.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $83.18 / $194.98	Professional	26	$50.12	$83.18	$194.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $147.91 / $281.84	Professional	TC	$93.33	$147.91	$281.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $229.09 / $870.96	Professional		$147.91	$229.09	$870.96
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $81.28 / $302.00	Professional	26	$52.48	$81.28	$302.00
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $177.83 / $562.34	Professional	TC	$95.50	$177.83	$562.34
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $141.25 / $165.96 / $263.03	Facility	26	$141.25	$165.96	$263.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $363.08 / $616.60	Professional		$151.36	$363.08	$616.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $112.20 / $218.78	Professional	26	$48.98	$112.20	$218.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $263.03 / $398.11	Professional	TC	$102.33	$263.03	$398.11
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $331.13 / $457.09	Professional		$275.42	$331.13	$457.09
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $117.49 / $158.49	Professional	26	$97.72	$117.49	$158.49
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $213.80 / $295.12	Professional	TC	$177.83	$213.80	$295.12
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $501.19 / $501.19 / $501.19	Facility	26	$501.19	$501.19	$501.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $380.19 / $1,548.82	Professional		$190.55	$380.19	$1,548.82
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $120.23 / $363.08	Professional	26	$57.54	$120.23	$363.08
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $263.03 / $1,258.93	Professional	TC	$123.03	$263.03	$1,258.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $245.47	Professional		$32.36	$33.11	$245.47
Quartz Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $380.19 / $1,047.13	Professional		$194.98	$380.19	$1,047.13
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $123.03 / $489.78 / $489.78	Facility	26	$123.03	$489.78	$489.78
Quartz Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $891.25 / $1,584.89	Professional		$218.78	$891.25	$1,584.89
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $281.84 / $363.08	Professional	26	$67.61	$281.84	$363.08
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $707.95 / $1,288.25	Professional	TC	$147.91	$707.95	$1,288.25
Security Health Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $741.31 / $1,202.26	Professional		$467.74	$741.31	$1,202.26
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $186.21 / $194.98 / $251.19	Professional	26	$186.21	$194.98	$251.19
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $338.84 / $478.63	Professional	TC	$288.40	$338.84	$478.63
United Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $288.40 / $602.56	Professional		$165.96	$288.40	$602.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $89.13 / $204.17	Professional	26	$57.54	$89.13	$204.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $199.53 / $446.68	Professional	TC	$107.15	$199.53	$446.68