Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $147.44 / $294.02 / $545.16	Facility		$147.44	$294.02	$545.16
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.11 / $17.43 / $64.97	Facility	26	$13.11	$17.43	$64.97
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $35.75 / $318.38 / $415.48	Facility	TC	$35.75	$318.38	$415.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.22 / $32.40 / $166.25	Professional		$20.22	$32.40	$166.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.03 / $13.11 / $67.98	Professional	26	$8.03	$13.11	$67.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.66 / $18.25 / $49.40	Professional	TC	$10.66	$18.25	$49.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.98 / $50.70 / $139.09	Professional		$23.98	$50.70	$139.09
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.46 / $19.54 / $54.44	Professional	26	$8.46	$19.54	$54.44
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $14.96 / $32.08 / $93.32	Professional	TC	$14.96	$32.08	$93.32
CareSource Facility/Professional Facility Modifier Low / Median / High Price $9.03 / $19.97 / $32.02	Facility		$9.03	$19.97	$32.02
CareSource Facility/Professional Professional Modifier Low / Median / High Price $9.68 / $20.74 / $35.15	Professional		$9.68	$20.74	$35.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $68.48 / $80.03 / $106.37	Facility		$68.48	$80.03	$106.37
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.63 / $25.27 / $33.59	Facility	26	$21.63	$25.27	$33.59
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $46.86 / $54.76 / $72.78	Facility	TC	$46.86	$54.76	$72.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.72 / $89.68 / $101.91	Professional		$23.72	$89.68	$101.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.35 / $29.48 / $33.50	Professional	26	$10.35	$29.48	$33.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.08 / $60.20 / $68.41	Professional	TC	$13.08	$60.20	$68.41
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $21.89 / $30.71 / $50.50	Facility		$21.89	$30.71	$50.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $22.58 / $123.20 / $290.64	Facility		$22.58	$123.20	$290.64
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $62.70 / $70.00 / $103.50	Facility	26	$62.70	$70.00	$103.50
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $96.41 / $233.51 / $345.48	Facility	TC	$96.41	$233.51	$345.48
Medica Facility/Professional Professional Modifier Low / Median / High Price $24.68 / $56.94 / $165.42	Professional		$24.68	$56.94	$165.42
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.81 / $28.20 / $73.67	Professional	26	$10.81	$28.20	$73.67
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $15.67 / $35.77 / $110.07	Professional	TC	$15.67	$35.77	$110.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.34 / $33.89 / $70.00	Professional		$19.34	$33.89	$70.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $21.89 / $34.24 / $50.50	Facility		$21.89	$34.24	$50.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $38.33 / $61.53 / $88.58	Professional		$38.33	$61.53	$88.58
Quartz Facility/Professional Facility Modifier Low / Median / High Price $63.48 / $342.77 / $342.77	Facility		$63.48	$342.77	$342.77
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $20.03 / $70.00 / $70.00	Facility	26	$20.03	$70.00	$70.00
Quartz Facility/Professional Facility Modifier TC Low / Median / High Price $40.90 / $78.72 / $78.72	Facility	TC	$40.90	$78.72	$78.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $37.77 / $122.70 / $165.42	Professional		$37.77	$122.70	$165.42
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $13.51 / $45.05 / $55.28	Professional	26	$13.51	$45.05	$55.28
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $25.35 / $77.65 / $110.07	Professional	TC	$25.35	$77.65	$110.07
Security Health Facility/Professional Professional Modifier Low / Median / High Price $38.29 / $159.79 / $159.79	Professional		$38.29	$159.79	$159.79
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.05 / $20.05 / $41.23	Professional	26	$17.05	$20.05	$41.23
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.11 / $22.48 / $75.43	Professional	TC	$19.11	$22.48	$75.43
United Facility/Professional Facility Modifier Low / Median / High Price $104.04 / $104.04 / $104.04	Facility		$104.04	$104.04	$104.04
United Facility/Professional Professional Modifier Low / Median / High Price $39.70 / $87.90 / $160.29	Professional		$39.70	$87.90	$160.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.83 / $21.11 / $39.53	Professional	26	$9.83	$21.11	$39.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.89 / $33.39 / $66.47	Professional	TC	$15.89	$33.39	$66.47