Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $146.32 / $163.36 / $187.86	Facility	26	$146.32	$163.36	$187.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $348.72 / $598.50 / $1,320.50	Professional		$348.72	$598.50	$1,320.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.42 / $163.36 / $790.50	Professional	26	$71.42	$163.36	$790.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $274.93 / $421.82 / $641.41	Professional	TC	$274.93	$421.82	$641.41
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $331.19 / $844.52 / $2,700.09	Professional		$331.19	$844.52	$2,700.09
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $68.06 / $167.20 / $534.92	Professional	26	$68.06	$167.20	$534.92
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $263.12 / $670.95 / $2,149.01	Professional	TC	$263.12	$670.95	$2,149.01
CareSource Facility/Professional Professional Modifier Low / Median / High Price $77.73 / $301.61 / $452.42	Professional		$77.73	$301.61	$452.42
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $182.93 / $213.77 / $284.11	Facility	26	$182.93	$213.77	$284.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $481.47 / $1,192.04 / $1,354.59	Professional		$481.47	$1,192.04	$1,354.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $98.26 / $245.50 / $278.98	Professional	26	$98.26	$245.50	$278.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $380.67 / $946.54 / $1,075.60	Professional	TC	$380.67	$946.54	$1,075.60
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $656.72 / $656.72 / $656.72	Facility	26	$656.72	$656.72	$656.72
Medica Facility/Professional Professional Modifier Low / Median / High Price $430.18 / $1,185.66 / $5,311.18	Professional		$430.18	$1,185.66	$5,311.18
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $83.54 / $197.59 / $808.00	Professional	26	$83.54	$197.59	$808.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $342.36 / $972.87 / $4,858.99	Professional	TC	$342.36	$972.87	$4,858.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.30 / $222.88 / $562.98	Professional		$54.30	$222.88	$562.98
Quartz Facility/Professional Professional Modifier Low / Median / High Price $652.60 / $977.70 / $2,197.44	Professional		$652.60	$977.70	$2,197.44
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $166.78 / $656.72 / $656.72	Facility	26	$166.78	$656.72	$656.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $516.71 / $2,896.79 / $5,311.18	Professional		$516.71	$2,896.79	$5,311.18
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $103.40 / $375.00 / $808.00	Professional	26	$103.40	$375.00	$808.00
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $434.00 / $2,616.54 / $4,858.99	Professional	TC	$434.00	$2,616.54	$4,858.99
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,087.85 / $2,124.12 / $3,896.83	Professional		$2,087.85	$2,124.12	$3,896.83
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $395.12 / $486.12 / $644.77	Professional	26	$395.12	$486.12	$644.77
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,492.27 / $2,982.81 / $3,547.75	Professional	TC	$1,492.27	$2,982.81	$3,547.75
United Facility/Professional Professional Modifier Low / Median / High Price $397.26 / $967.90 / $2,080.83	Professional		$397.26	$967.90	$2,080.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $78.38 / $167.10 / $320.70	Professional	26	$78.38	$167.10	$320.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $313.72 / $760.97 / $2,147.61	Professional	TC	$313.72	$760.97	$2,147.61