Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $226.91 / $253.44 / $291.45	Facility	26	$226.91	$253.44	$291.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $339.62 / $770.57 / $3,837.05	Professional		$339.62	$770.57	$3,837.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $109.61 / $311.18 / $1,306.26	Professional	26	$109.61	$311.18	$1,306.26
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $164.93 / $237.50 / $450.78	Professional	52	$164.93	$237.50	$450.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $225.18 / $406.56 / $1,464.67	Professional	TC	$225.18	$406.56	$1,464.67
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $321.07 / $772.24 / $2,527.94	Professional		$321.07	$772.24	$2,527.94
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $105.60 / $251.09 / $826.59	Professional	26	$105.60	$251.09	$826.59
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $215.47 / $528.51 / $1,701.35	Professional	TC	$215.47	$528.51	$1,701.35
CareSource Facility/Professional Professional Modifier Low / Median / High Price $120.68 / $257.54 / $439.65	Professional		$120.68	$257.54	$439.65
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $283.85 / $331.70 / $440.86	Facility	26	$283.85	$331.70	$440.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $465.81 / $1,151.82 / $1,308.89	Professional		$465.81	$1,151.82	$1,308.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $128.38 / $379.20 / $430.91	Professional	26	$128.38	$379.20	$430.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $309.50 / $772.62 / $972.53	Professional	TC	$309.50	$772.62	$972.53
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $1,013.76 / $1,013.76 / $2,115.50	Facility	26	$1,013.76	$1,013.76	$2,115.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $458.91 / $1,211.61 / $6,146.58	Professional		$458.91	$1,211.61	$6,146.58
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $135.65 / $367.38 / $1,390.05	Professional	26	$135.65	$367.38	$1,390.05
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $311.95 / $818.29 / $5,551.18	Professional	TC	$311.95	$818.29	$5,551.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $80.83 / $191.29 / $555.06	Professional		$80.83	$191.29	$555.06
Quartz Facility/Professional Professional Modifier Low / Median / High Price $631.15 / $945.56 / $2,870.23	Professional		$631.15	$945.56	$2,870.23
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $257.60 / $1,013.76 / $1,013.76	Facility	26	$257.60	$1,013.76	$1,013.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $547.71 / $3,347.26 / $6,146.58	Professional		$547.71	$3,347.26	$6,146.58
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $159.69 / $565.20 / $921.60	Professional	26	$159.69	$565.20	$921.60
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $329.04 / $2,979.62 / $5,551.18	Professional	TC	$329.04	$2,979.62	$5,551.18
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,038.90 / $4,523.03 / $4,523.03	Professional		$2,038.90	$4,523.03	$4,523.03
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $481.95 / $1,412.13 / $1,412.13	Professional	26	$481.95	$1,412.13	$1,412.13
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,419.81 / $3,110.91 / $3,110.91	Professional	TC	$1,419.81	$3,110.91	$3,110.91
United Facility/Professional Professional Modifier Low / Median / High Price $402.43 / $974.80 / $2,638.30	Professional		$402.43	$974.80	$2,638.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $128.22 / $294.05 / $495.40	Professional	26	$128.22	$294.05	$495.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $287.95 / $647.91 / $1,948.78	Professional	TC	$287.95	$647.91	$1,948.78