Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $147.91 / $186.21 / $275.42	Facility	26	$147.91	$186.21	$275.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $537.03 / $1,380.38	Professional		$338.84	$537.03	$1,380.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $141.25 / $588.84	Professional	26	$70.79	$141.25	$588.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $354.81 / $707.95	Professional	TC	$263.03	$354.81	$707.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $602.56 / $1,949.84	Professional		$331.13	$602.56	$1,949.84
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $107.15 / $398.11	Professional	26	$67.61	$107.15	$398.11
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $537.03 / $1,659.59	Professional	TC	$263.03	$537.03	$1,659.59
CareSource Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $316.23 / $407.38	Professional		$89.13	$316.23	$407.38
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $181.97 / $213.80 / $338.84	Facility	26	$181.97	$213.80	$338.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $1,023.29 / $1,380.38	Professional		$478.63	$1,023.29	$1,380.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $173.78 / $281.84	Professional	26	$69.18	$173.78	$281.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $380.19 / $812.83 / $1,096.48	Professional	TC	$380.19	$812.83	$1,096.48
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $741.31 / $1,230.27	Professional		$616.60	$741.31	$1,230.27
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $154.88 / $208.93	Professional	26	$128.82	$154.88	$208.93
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $489.78 / $588.84 / $1,047.13	Professional	TC	$489.78	$588.84	$1,047.13
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $660.69 / $660.69 / $660.69	Facility	26	$660.69	$660.69	$660.69
Medica Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $1,047.13 / $5,370.32	Professional		$426.58	$1,047.13	$5,370.32
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $169.82 / $812.83	Professional	26	$79.43	$169.82	$812.83
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $891.25 / $4,897.79	Professional	TC	$338.84	$891.25	$4,897.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $933.25	Professional		$32.36	$33.11	$933.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $831.76 / $2,187.76	Professional		$426.58	$831.76	$2,187.76
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $162.18 / $645.65 / $645.65	Facility	26	$162.18	$645.65	$645.65
Quartz Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $3,019.95 / $5,495.41	Professional		$524.81	$3,019.95	$5,495.41
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $371.54 / $812.83	Professional	26	$100.00	$371.54	$812.83
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $426.58 / $2,754.23 / $5,011.87	Professional	TC	$426.58	$2,754.23	$5,011.87
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $3,019.95 / $3,981.07	Professional		$1,995.26	$3,019.95	$3,981.07
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $331.13 / $524.81 / $660.69	Professional	26	$331.13	$524.81	$660.69
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,348.96 / $2,951.21 / $3,630.78	Professional	TC	$1,348.96	$2,951.21	$3,630.78
United Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $794.33 / $1,737.80	Professional		$380.19	$794.33	$1,737.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $120.23 / $269.15	Professional	26	$75.86	$120.23	$269.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $660.69 / $1,479.11	Professional	TC	$302.00	$660.69	$1,479.11