Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.26 / $112.01 / $119.89	Facility	26	$104.26	$112.01	$119.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.43 / $304.70 / $892.76	Professional		$165.43	$304.70	$892.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.08 / $104.26 / $422.80	Professional	26	$54.08	$104.26	$422.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $109.53 / $200.45 / $379.60	Professional	TC	$109.53	$200.45	$379.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $152.36 / $362.27 / $1,194.63	Professional		$152.36	$362.27	$1,194.63
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.13 / $123.95 / $406.38	Professional	26	$52.13	$123.95	$406.38
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $100.23 / $238.62 / $788.25	Professional	TC	$100.23	$238.62	$788.25
CareSource Facility/Professional Professional Modifier Low / Median / High Price $59.47 / $121.04 / $209.91	Professional		$59.47	$121.04	$209.91
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $139.66 / $163.22 / $216.93	Facility	26	$139.66	$163.22	$216.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $222.39 / $548.49 / $623.29	Professional		$222.39	$548.49	$623.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.80 / $186.58 / $212.03	Professional	26	$70.80	$186.58	$212.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $145.24 / $361.91 / $411.26	Professional	TC	$145.24	$361.91	$411.26
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $498.88 / $498.88 / $498.88	Facility	26	$498.88	$498.88	$498.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $194.03 / $488.46 / $1,708.01	Professional		$194.03	$488.46	$1,708.01
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $66.34 / $151.08 / $384.71	Professional	26	$66.34	$151.08	$384.71
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $127.13 / $344.30 / $2,023.00	Professional	TC	$127.13	$344.30	$2,023.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $56.22 / $105.44 / $253.92	Professional		$56.22	$105.44	$253.92
Quartz Facility/Professional Professional Modifier Low / Median / High Price $300.95 / $450.87 / $993.30	Professional		$300.95	$450.87	$993.30
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $126.75 / $498.88 / $498.88	Facility	26	$126.75	$498.88	$498.88
Quartz Facility/Professional Professional Modifier Low / Median / High Price $236.96 / $977.97 / $1,708.01	Professional		$236.96	$977.97	$1,708.01
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $78.58 / $278.75 / $384.71	Professional	26	$78.58	$278.75	$384.71
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $152.41 / $764.51 / $2,023.00	Professional	TC	$152.41	$764.51	$2,023.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $542.85 / $977.29 / $977.29	Professional		$542.85	$977.29	$977.29
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $186.54 / $227.59 / $350.17	Professional	26	$186.54	$227.59	$350.17
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $356.31 / $450.84 / $1,192.08	Professional	TC	$356.31	$450.84	$1,192.08
United Facility/Professional Professional Modifier Low / Median / High Price $186.95 / $393.15 / $793.27	Professional		$186.95	$393.15	$793.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $73.00 / $98.00 / $337.41	Professional	26	$73.00	$98.00	$337.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $120.74 / $275.58 / $594.65	Professional	TC	$120.74	$275.58	$594.65