Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.50 / $127.35 / $127.35	Facility	26	$118.50	$127.35	$127.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.96 / $279.24 / $924.61	Professional		$162.96	$279.24	$924.61
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.53 / $92.73 / $363.28	Professional	26	$58.53	$92.73	$363.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $99.72 / $182.42 / $308.00	Professional	TC	$99.72	$182.42	$308.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $150.46 / $366.44 / $1,178.40	Professional		$150.46	$366.44	$1,178.40
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $59.25 / $140.88 / $463.11	Professional	26	$59.25	$140.88	$463.11
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $91.21 / $221.58 / $715.29	Professional	TC	$91.21	$221.58	$715.29
CareSource Facility/Professional Professional Modifier Low / Median / High Price $67.63 / $109.85 / $207.80	Professional		$67.63	$109.85	$207.80
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $158.60 / $185.33 / $246.32	Facility	26	$158.60	$185.33	$246.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $219.84 / $541.05 / $614.84	Professional		$219.84	$541.05	$614.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.64 / $212.38 / $241.34	Professional	26	$69.64	$212.38	$241.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $132.11 / $328.68 / $373.50	Professional	TC	$132.11	$328.68	$373.50
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $568.24 / $568.24 / $568.24	Facility	26	$568.24	$568.24	$568.24
Medica Facility/Professional Professional Modifier Low / Median / High Price $191.21 / $439.62 / $1,403.43	Professional		$191.21	$439.62	$1,403.43
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $72.23 / $167.29 / $384.88	Professional	26	$72.23	$167.29	$384.88
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $115.21 / $308.29 / $1,332.00	Professional	TC	$115.21	$308.29	$1,332.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $56.22 / $105.44 / $253.57	Professional		$56.22	$105.44	$253.57
Quartz Facility/Professional Professional Modifier Low / Median / High Price $297.05 / $445.03 / $721.87	Professional		$297.05	$445.03	$721.87
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $144.28 / $568.24 / $568.24	Facility	26	$144.28	$568.24	$568.24
Quartz Facility/Professional Professional Modifier Low / Median / High Price $227.88 / $803.10 / $1,403.43	Professional		$227.88	$803.10	$1,403.43
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $89.46 / $316.64 / $384.88	Professional	26	$89.46	$316.64	$384.88
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $140.22 / $592.02 / $1,332.00	Professional	TC	$140.22	$592.02	$1,332.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $531.60 / $964.09 / $964.09	Professional		$531.60	$964.09	$964.09
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $211.90 / $227.59 / $346.27	Professional	26	$211.90	$227.59	$346.27
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $330.45 / $413.51 / $902.78	Professional	TC	$330.45	$413.51	$902.78
United Facility/Professional Professional Modifier Low / Median / High Price $177.82 / $389.36 / $757.78	Professional		$177.82	$389.36	$757.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $82.33 / $239.41 / $487.27	Professional	26	$82.33	$239.41	$487.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $105.58 / $249.75 / $538.91	Professional	TC	$105.58	$249.75	$538.91