Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.71 / $120.23 / $120.23	Facility	26	$104.71	$120.23	$120.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $302.00 / $660.69	Professional		$181.97	$302.00	$660.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $97.72 / $239.88	Professional	26	$53.70	$97.72	$239.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $213.80 / $380.19	Professional	TC	$125.89	$213.80	$380.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $371.54 / $1,071.52	Professional		$181.97	$371.54	$1,071.52
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $95.50 / $302.00	Professional	26	$52.48	$95.50	$302.00
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $275.42 / $776.25	Professional	TC	$128.82	$275.42	$776.25
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 $234.42 / $478.63 / $758.58	Professional		$234.42	$478.63	$758.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $125.89 / $218.78	Professional	26	$54.95	$125.89	$218.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $346.74 / $537.03	Professional	TC	$177.83	$346.74	$537.03
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $407.38 / $691.83	Professional		$338.84	$407.38	$691.83
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $117.49 / $177.83	Professional	26	$97.72	$117.49	$177.83
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $288.40 / $524.81	Professional	TC	$239.88	$288.40	$524.81
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 $257.04 / $512.86 / $1,949.84	Professional		$257.04	$512.86	$1,949.84
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $131.83 / $562.34	Professional	26	$63.10	$131.83	$562.34
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $389.05 / $1,548.82	Professional	TC	$190.55	$389.05	$1,548.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $380.19	Professional		$32.36	$33.11	$380.19
Quartz Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $457.09 / $1,047.13	Professional		$234.42	$457.09	$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 $288.40 / $1,122.02 / $1,949.84	Professional		$288.40	$1,122.02	$1,949.84
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $281.84 / $562.34	Professional	26	$77.62	$281.84	$562.34
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $891.25 / $1,548.82	Professional	TC	$204.17	$891.25	$1,548.82
Security Health Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $1,096.48 / $1,548.82	Professional		$812.83	$1,096.48	$1,548.82
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $190.55 / $245.47 / $288.40	Professional	26	$190.55	$245.47	$288.40
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $467.74 / $660.69 / $831.76	Professional	TC	$467.74	$660.69	$831.76
United Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $398.11 / $831.76	Professional		$223.87	$398.11	$831.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $95.50 / $208.93	Professional	26	$57.54	$95.50	$208.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $309.03 / $645.65	Professional	TC	$162.18	$309.03	$645.65