Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $161.30 / $173.16 / $225.81	Facility	26	$161.30	$173.16	$225.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.12 / $502.53 / $1,547.26	Professional		$251.12	$502.53	$1,547.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.97 / $161.30 / $714.00	Professional	26	$75.97	$161.30	$714.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $170.48 / $341.24 / $976.14	Professional	TC	$170.48	$341.24	$976.14
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $276.16 / $642.11 / $2,156.89	Professional		$276.16	$642.11	$2,156.89
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $80.65 / $191.76 / $630.47	Professional	26	$80.65	$191.76	$630.47
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $195.51 / $456.77 / $1,508.35	Professional	TC	$195.51	$456.77	$1,508.35
CareSource Facility/Professional Professional Modifier Low / Median / High Price $91.98 / $236.86 / $380.52	Professional		$91.98	$236.86	$380.52
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $217.17 / $253.78 / $337.29	Facility	26	$217.17	$253.78	$337.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $403.84 / $994.16 / $1,129.73	Professional		$403.84	$994.16	$1,129.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.57 / $289.55 / $329.04	Professional	26	$95.57	$289.55	$329.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $284.55 / $704.64 / $800.73	Professional	TC	$284.55	$704.64	$800.73
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $616.54 / $773.84 / $1,673.00	Facility	26	$616.54	$773.84	$1,673.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $343.64 / $850.74 / $3,248.56	Professional		$343.64	$850.74	$3,248.56
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $101.43 / $247.13 / $880.00	Professional	26	$101.43	$247.13	$880.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $240.30 / $638.21 / $2,762.21	Professional	TC	$240.30	$638.21	$2,762.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $80.83 / $188.32 / $487.55	Professional		$80.83	$188.32	$487.55
Quartz Facility/Professional Professional Modifier Low / Median / High Price $546.65 / $723.79 / $1,202.11	Professional		$546.65	$723.79	$1,202.11
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $196.70 / $773.84 / $773.84	Facility	26	$196.70	$773.84	$773.84
Quartz Facility/Professional Professional Modifier Low / Median / High Price $429.82 / $1,544.28 / $3,248.56	Professional		$429.82	$1,544.28	$3,248.56
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $121.95 / $430.60 / $880.00	Professional	26	$121.95	$430.60	$880.00
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $296.77 / $1,271.96 / $2,762.21	Professional	TC	$296.77	$1,271.96	$2,762.21
Security Health Facility/Professional Professional Modifier Low / Median / High Price $823.23 / $1,629.47 / $1,629.47	Professional		$823.23	$1,629.47	$1,629.47
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $273.11 / $289.23 / $471.50	Professional	26	$273.11	$289.23	$471.50
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $657.71 / $758.63 / $2,435.73	Professional	TC	$657.71	$758.63	$2,435.73
United Facility/Professional Professional Modifier Low / Median / High Price $332.34 / $746.33 / $1,425.37	Professional		$332.34	$746.33	$1,425.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $94.03 / $201.38 / $418.40	Professional	26	$94.03	$201.38	$418.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $220.19 / $528.98 / $1,124.02	Professional	TC	$220.19	$528.98	$1,124.02