Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.07 / $115.58 / $150.61	Facility	26	$59.07	$115.58	$150.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $166.86 / $377.94 / $1,921.00	Professional		$166.86	$377.94	$1,921.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.11 / $107.58 / $537.10	Professional	26	$51.11	$107.58	$537.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $111.79 / $226.42 / $782.46	Professional	TC	$111.79	$226.42	$782.46
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $167.00 / $425.85 / $1,308.30	Professional		$167.00	$425.85	$1,308.30
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.79 / $127.89 / $419.42	Professional	26	$53.79	$127.89	$419.42
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $113.21 / $288.68 / $888.88	Professional	TC	$113.21	$288.68	$888.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $61.36 / $136.96 / $230.16	Professional		$61.36	$136.96	$230.16
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $145.08 / $169.54 / $225.33	Facility	26	$145.08	$169.54	$225.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $244.05 / $602.55 / $684.73	Professional		$244.05	$602.55	$684.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.06 / $193.77 / $220.19	Professional	26	$67.06	$193.77	$220.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $164.43 / $408.79 / $464.54	Professional	TC	$164.43	$408.79	$464.54
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $408.50 / $518.00 / $518.00	Facility	26	$408.50	$518.00	$518.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $227.70 / $593.86 / $1,890.30	Professional		$227.70	$593.86	$1,890.30
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $73.26 / $203.46 / $516.34	Professional	26	$73.26	$203.46	$516.34
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $153.84 / $416.65 / $1,576.92	Professional	TC	$153.84	$416.65	$1,576.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $56.22 / $130.87 / $312.33	Professional		$56.22	$130.87	$312.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $330.20 / $494.69 / $1,117.16	Professional		$330.20	$494.69	$1,117.16
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $131.63 / $518.00 / $518.00	Facility	26	$131.63	$518.00	$518.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $279.17 / $1,039.34 / $1,890.30	Professional		$279.17	$1,039.34	$1,890.30
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $81.61 / $307.75 / $450.76	Professional	26	$81.61	$307.75	$450.76
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $175.15 / $846.45 / $1,576.92	Professional	TC	$175.15	$846.45	$1,576.92
Security Health Facility/Professional Professional Modifier Low / Median / High Price $743.02 / $1,073.69 / $1,073.69	Professional		$743.02	$1,073.69	$1,073.69
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $194.81 / $233.66 / $336.56	Professional	26	$194.81	$233.66	$336.56
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $411.00 / $579.75 / $1,137.61	Professional	TC	$411.00	$579.75	$1,137.61
United Facility/Professional Professional Modifier Low / Median / High Price $211.17 / $474.38 / $1,293.42	Professional		$211.17	$474.38	$1,293.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $65.51 / $149.83 / $269.74	Professional	26	$65.51	$149.83	$269.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $139.81 / $320.50 / $695.20	Professional	TC	$139.81	$320.50	$695.20