Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.43 / $91.20 / $134.90	Facility	26	$79.43	$91.20	$134.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $275.42 / $1,122.02	Professional		$131.83	$275.42	$1,122.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $72.44 / $309.03	Professional	26	$38.02	$72.44	$309.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $158.49 / $346.74	Professional	TC	$89.13	$158.49	$346.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $234.42 / $741.31	Professional		$128.82	$234.42	$741.31
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $63.10 / $229.09	Professional	26	$39.81	$63.10	$229.09
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $165.96 / $512.86	Professional	TC	$89.13	$165.96	$512.86
CareSource Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $107.15 / $165.96	Professional		$51.29	$107.15	$165.96
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $107.15 / $123.03 / $199.53	Facility	26	$107.15	$123.03	$199.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $338.84 / $537.03	Professional		$144.54	$338.84	$537.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $87.10 / $165.96	Professional	26	$39.81	$87.10	$165.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $239.88 / $371.54	Professional	TC	$112.20	$239.88	$371.54
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $288.40 / $389.05	Professional		$239.88	$288.40	$389.05
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $89.13 / $114.82	Professional	26	$74.13	$89.13	$114.82
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $199.53 / $269.15	Professional	TC	$165.96	$199.53	$269.15
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $302.00 / $380.19 / $851.14	Facility	26	$302.00	$380.19	$851.14
Medica Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $354.81 / $1,412.54	Professional		$162.18	$354.81	$1,412.54
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $134.90 / $501.19	Professional	26	$50.12	$134.90	$501.19
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $245.47 / $1,230.27	Professional	TC	$109.65	$245.47	$1,230.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $257.04	Professional		$32.36	$33.11	$257.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $323.59 / $724.44	Professional		$165.96	$323.59	$724.44
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $371.54 / $371.54	Facility	26	$100.00	$371.54	$371.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $794.33 / $1,412.54	Professional		$199.53	$794.33	$1,412.54
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $208.93 / $331.13	Professional	26	$58.88	$208.93	$331.13
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $616.60 / $1,230.27	Professional	TC	$138.04	$616.60	$1,230.27
Security Health Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $724.44 / $1,548.82	Professional		$446.68	$724.44	$1,548.82
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $141.25 / $194.98 / $436.52	Professional	26	$141.25	$194.98	$436.52
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $309.03 / $489.78 / $1,096.48	Professional	TC	$309.03	$489.78	$1,096.48
United Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $269.15 / $549.54	Professional		$141.25	$269.15	$549.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $72.44 / $154.88	Professional	26	$43.65	$72.44	$154.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $190.55 / $398.11	Professional	TC	$97.72	$190.55	$398.11