Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $127.86 / $136.71 / $147.03	Facility	26	$127.86	$136.71	$147.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $201.06 / $410.16 / $2,074.00	Professional		$201.06	$410.16	$2,074.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.95 / $145.72 / $620.50	Professional	26	$62.95	$145.72	$620.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $119.73 / $242.52 / $780.37	Professional	TC	$119.73	$242.52	$780.37
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $185.19 / $440.32 / $1,454.18	Professional		$185.19	$440.32	$1,454.18
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $63.93 / $152.00 / $499.88	Professional	26	$63.93	$152.00	$499.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $121.26 / $295.07 / $954.29	Professional	TC	$121.26	$295.07	$954.29
CareSource Facility/Professional Professional Modifier Low / Median / High Price $72.59 / $145.71 / $254.04	Professional		$72.59	$145.71	$254.04
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $171.21 / $200.08 / $265.92	Facility	26	$171.21	$200.08	$265.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $269.16 / $665.08 / $755.78	Professional		$269.16	$665.08	$755.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.03 / $229.35 / $260.63	Professional	26	$75.03	$229.35	$260.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $174.98 / $435.77 / $495.19	Professional	TC	$174.98	$435.77	$495.19
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $612.88 / $612.88 / $1,248.50	Facility	26	$612.88	$612.88	$1,248.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $235.42 / $539.36 / $1,680.90	Professional		$235.42	$539.36	$1,680.90
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $80.48 / $194.21 / $476.68	Professional	26	$80.48	$194.21	$476.68
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $153.44 / $400.19 / $1,425.00	Professional	TC	$153.44	$400.19	$1,425.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.30 / $126.15 / $307.93	Professional		$54.30	$126.15	$307.93
Quartz Facility/Professional Professional Modifier Low / Median / High Price $364.00 / $545.33 / $955.63	Professional		$364.00	$545.33	$955.63
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $155.80 / $612.88 / $612.88	Facility	26	$155.80	$612.88	$612.88
Quartz Facility/Professional Professional Modifier Low / Median / High Price $280.12 / $980.90 / $1,680.90	Professional		$280.12	$980.90	$1,680.90
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $96.59 / $341.55 / $414.94	Professional	26	$96.59	$341.55	$414.94
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $186.28 / $735.56 / $1,425.00	Professional	TC	$186.28	$735.56	$1,425.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $762.61 / $1,185.08 / $1,185.08	Professional		$762.61	$1,185.08	$1,185.08
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $228.99 / $242.76 / $373.36	Professional	26	$228.99	$242.76	$373.36
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $438.12 / $573.52 / $1,131.97	Professional	TC	$438.12	$573.52	$1,131.97
United Facility/Professional Professional Modifier Low / Median / High Price $226.49 / $510.32 / $859.76	Professional		$226.49	$510.32	$859.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.51 / $164.63 / $299.37	Professional	26	$74.51	$164.63	$299.37
United Facility/Professional Professional Modifier TC Low / Median / High Price $145.27 / $314.64 / $636.32	Professional	TC	$145.27	$314.64	$636.32