Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $117.18 / $125.91 / $125.91	Facility	26	$117.18	$125.91	$125.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $174.37 / $314.95 / $597.54	Professional		$174.37	$314.95	$597.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.24 / $92.86 / $586.50	Professional	26	$58.24	$92.86	$586.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $119.70 / $230.93 / $418.57	Professional	TC	$119.70	$230.93	$418.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $174.05 / $413.85 / $1,366.93	Professional		$174.05	$413.85	$1,366.93
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.59 / $139.31 / $460.45	Professional	26	$58.59	$139.31	$460.45
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $115.46 / $274.61 / $906.49	Professional	TC	$115.46	$274.61	$906.49
CareSource Facility/Professional Professional Modifier Low / Median / High Price $66.89 / $138.94 / $239.31	Professional		$66.89	$138.94	$239.31
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $157.69 / $184.28 / $244.92	Facility	26	$157.69	$184.28	$244.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $247.18 / $625.80 / $711.15	Professional		$247.18	$625.80	$711.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.27 / $211.17 / $239.96	Professional	26	$69.27	$211.17	$239.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $165.70 / $414.65 / $471.19	Professional	TC	$165.70	$414.65	$471.19
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $565.04 / $565.04 / $565.04	Facility	26	$565.04	$565.04	$565.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $222.01 / $556.04 / $1,897.57	Professional		$222.01	$556.04	$1,897.57
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $71.45 / $165.44 / $435.88	Professional	26	$71.45	$165.44	$435.88
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $146.85 / $383.01 / $1,600.00	Professional	TC	$146.85	$383.01	$1,600.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $56.22 / $130.87 / $312.33	Professional		$56.22	$130.87	$312.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $343.20 / $514.16 / $1,166.02	Professional		$343.20	$514.16	$1,166.02
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $143.44 / $565.04 / $565.04	Facility	26	$143.44	$565.04	$565.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $289.94 / $1,045.02 / $1,897.57	Professional		$289.94	$1,045.02	$1,897.57
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $88.94 / $313.14 / $435.88	Professional	26	$88.94	$313.14	$435.88
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $174.64 / $846.45 / $1,600.00	Professional	TC	$174.64	$846.45	$1,600.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $621.91 / $1,115.16 / $1,115.16	Professional		$621.91	$1,115.16	$1,115.16
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $210.70 / $224.55 / $342.43	Professional	26	$210.70	$224.55	$342.43
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $411.22 / $520.32 / $885.89	Professional	TC	$411.22	$520.32	$885.89
United Facility/Professional Professional Modifier Low / Median / High Price $213.31 / $481.26 / $852.76	Professional		$213.31	$481.26	$852.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $68.36 / $146.16 / $274.48	Professional	26	$68.36	$146.16	$274.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $140.41 / $323.27 / $686.93	Professional	TC	$140.41	$323.27	$686.93