Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.49 / $133.12 / $153.08	Facility	26	$118.49	$133.12	$153.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $236.28 / $494.18 / $895.94	Professional		$236.28	$494.18	$895.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.22 / $145.65 / $637.50	Professional	26	$58.22	$145.65	$637.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $176.35 / $338.54 / $507.50	Professional	TC	$176.35	$338.54	$507.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $216.64 / $552.44 / $1,709.40	Professional		$216.64	$552.44	$1,709.40
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $55.47 / $131.88 / $434.20	Professional	26	$55.47	$131.88	$434.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $161.18 / $411.00 / $1,330.40	Professional	TC	$161.18	$411.00	$1,330.40
CareSource Facility/Professional Professional Modifier Low / Median / High Price $62.90 / $188.64 / $296.31	Professional		$62.90	$188.64	$296.31
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $148.68 / $173.75 / $230.93	Facility	26	$148.68	$173.75	$230.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $314.83 / $779.05 / $885.29	Professional		$314.83	$779.05	$885.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.15 / $198.69 / $225.79	Professional	26	$65.15	$198.69	$225.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $233.21 / $580.36 / $659.50	Professional	TC	$233.21	$580.36	$659.50
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $530.79 / $530.79 / $530.79	Facility	26	$530.79	$530.79	$530.79
Medica Facility/Professional Professional Modifier Low / Median / High Price $284.06 / $760.18 / $2,968.23	Professional		$284.06	$760.18	$2,968.23
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $67.37 / $153.66 / $505.24	Professional	26	$67.37	$153.66	$505.24
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $213.18 / $607.96 / $2,638.88	Professional	TC	$213.18	$607.96	$2,638.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.40 / $165.45 / $380.07	Professional		$58.40	$165.45	$380.07
Quartz Facility/Professional Professional Modifier Low / Median / High Price $426.40 / $638.80 / $1,122.86	Professional		$426.40	$638.80	$1,122.86
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $134.97 / $530.79 / $530.79	Facility	26	$134.97	$530.79	$530.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $337.86 / $1,528.39 / $2,968.23	Professional		$337.86	$1,528.39	$2,968.23
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $83.68 / $295.35 / $505.24	Professional	26	$83.68	$295.35	$505.24
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $268.88 / $1,341.18 / $2,638.88	Professional	TC	$268.88	$1,341.18	$2,638.88
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,367.98 / $1,388.14 / $2,578.46	Professional		$1,367.98	$1,388.14	$2,578.46
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $285.60 / $323.08 / $431.07	Professional	26	$285.60	$323.08	$431.07
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $914.19 / $1,946.82 / $2,315.55	Professional	TC	$914.19	$1,946.82	$2,315.55
United Facility/Professional Professional Modifier Low / Median / High Price $262.76 / $625.32 / $1,356.82	Professional		$262.76	$625.32	$1,356.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.48 / $143.62 / $331.57	Professional	26	$64.48	$143.62	$331.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $195.34 / $479.65 / $1,031.19	Professional	TC	$195.34	$479.65	$1,031.19