Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $213.01 / $237.16 / $272.73	Facility	26	$213.01	$237.16	$272.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $372.67 / $611.94 / $2,746.55	Professional		$372.67	$611.94	$2,746.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $103.68 / $237.16 / $705.60	Professional	26	$103.68	$237.16	$705.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $254.43 / $393.65 / $673.32	Professional	TC	$254.43	$393.65	$673.32
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $342.30 / $850.00 / $2,701.09	Professional		$342.30	$850.00	$2,701.09
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $98.82 / $234.96 / $773.31	Professional	26	$98.82	$234.96	$773.31
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $243.48 / $620.88 / $1,927.78	Professional	TC	$243.48	$620.88	$1,927.78
CareSource Facility/Professional Professional Modifier Low / Median / High Price $113.27 / $289.37 / $466.17	Professional		$113.27	$289.37	$466.17
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $265.83 / $310.64 / $412.87	Facility	26	$265.83	$310.64	$412.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $494.61 / $1,225.72 / $1,392.86	Professional		$494.61	$1,225.72	$1,392.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $115.25 / $355.76 / $404.28	Professional	26	$115.25	$355.76	$404.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $347.88 / $869.91 / $1,041.68	Professional	TC	$347.88	$869.91	$1,041.68
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $950.80 / $950.80 / $950.80	Facility	26	$950.80	$950.80	$950.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $489.89 / $1,285.02 / $5,981.06	Professional		$489.89	$1,285.02	$5,981.06
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $126.84 / $290.44 / $883.52	Professional	26	$126.84	$290.44	$883.52
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $352.48 / $924.58 / $5,438.76	Professional	TC	$352.48	$924.58	$5,438.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $80.83 / $207.99 / $615.87	Professional		$80.83	$207.99	$615.87
Quartz Facility/Professional Professional Modifier Low / Median / High Price $670.15 / $1,003.99 / $2,455.46	Professional		$670.15	$1,003.99	$2,455.46
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $241.68 / $950.80 / $950.80	Facility	26	$241.68	$950.80	$950.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $527.66 / $3,262.16 / $5,981.06	Professional		$527.66	$3,262.16	$5,981.06
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $149.84 / $528.50 / $883.52	Professional	26	$149.84	$528.50	$883.52
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $369.55 / $2,926.31 / $5,438.76	Professional	TC	$369.55	$2,926.31	$5,438.76
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,124.15 / $2,184.05 / $3,108.53	Professional		$2,124.15	$2,184.05	$3,108.53
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $455.18 / $578.22 / $767.66	Professional	26	$455.18	$578.22	$767.66
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,363.70 / $1,811.33 / $2,589.77	Professional	TC	$1,363.70	$1,811.33	$2,589.77
United Facility/Professional Professional Modifier Low / Median / High Price $452.21 / $995.46 / $2,165.44	Professional		$452.21	$995.46	$2,165.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $120.24 / $264.25 / $463.23	Professional	26	$120.24	$264.25	$463.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $325.37 / $716.24 / $1,787.18	Professional	TC	$325.37	$716.24	$1,787.18