Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $147.91 / $177.83	Facility	26	$70.79	$147.91	$177.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $354.81 / $1,479.11	Professional		$186.21	$354.81	$1,479.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $117.49 / $380.19	Professional	26	$61.66	$117.49	$380.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $208.93 / $467.74	Professional	TC	$120.23	$208.93	$467.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $288.40 / $1,071.52	Professional		$186.21	$288.40	$1,071.52
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $100.00 / $371.54	Professional	26	$64.57	$100.00	$371.54
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $213.80 / $707.95	Professional	TC	$120.23	$213.80	$707.95
CareSource Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $147.91 / $239.88	Professional		$83.18	$147.91	$239.88
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $169.82 / $199.53 / $316.23	Facility	26	$169.82	$199.53	$316.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $457.09 / $776.25	Professional		$199.53	$457.09	$776.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $134.90 / $263.03	Professional	26	$60.26	$134.90	$263.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $316.23 / $501.19	Professional	TC	$144.54	$316.23	$501.19
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $416.87 / $562.34	Professional		$346.74	$416.87	$562.34
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $144.54 / $194.98	Professional	26	$120.23	$144.54	$194.98
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $269.15 / $338.84	Professional	TC	$223.87	$269.15	$338.84
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $616.60 / $616.60 / $1,258.93	Facility	26	$616.60	$616.60	$1,258.93
Medica Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $478.63 / $1,698.24	Professional		$234.42	$478.63	$1,698.24
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $186.21 / $602.56	Professional	26	$74.13	$186.21	$602.56
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $316.23 / $1,412.54	Professional	TC	$154.88	$316.23	$1,412.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $302.00	Professional		$32.36	$33.11	$302.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $467.74 / $954.99	Professional		$239.88	$467.74	$954.99
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $151.36 / $602.56 / $602.56	Facility	26	$151.36	$602.56	$602.56
Quartz Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $977.24 / $1,698.24	Professional		$269.15	$977.24	$1,698.24
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $338.84 / $416.87	Professional	26	$81.28	$338.84	$416.87
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $741.31 / $1,412.54	Professional	TC	$186.21	$741.31	$1,412.54
Security Health Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $954.99 / $1,513.56	Professional		$758.58	$954.99	$1,513.56
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $229.09 / $245.47 / $309.03	Professional	26	$229.09	$245.47	$309.03
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $436.52 / $575.44 / $676.08	Professional	TC	$436.52	$575.44	$676.08
United Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $363.08 / $741.31	Professional		$208.93	$363.08	$741.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $109.65 / $245.47	Professional	26	$70.79	$109.65	$245.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $257.04 / $512.86	Professional	TC	$134.90	$257.04	$512.86