Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.88 / $123.03 / $181.97	Facility	26	$58.88	$123.03	$181.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $316.23 / $1,288.25	Professional		$128.82	$316.23	$1,288.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $60.26 / $309.03	Professional	26	$50.12	$60.26	$309.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $177.83 / $436.52	Professional	TC	$85.11	$177.83	$436.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $281.84 / $977.24	Professional		$165.96	$281.84	$977.24
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $85.11 / $316.23	Professional	26	$53.70	$85.11	$316.23
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $218.78 / $660.69	Professional	TC	$112.20	$218.78	$660.69
CareSource Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $138.04 / $218.78	Professional		$70.79	$138.04	$218.78
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $144.54 / $169.82 / $269.15	Facility	26	$144.54	$169.82	$269.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $457.09 / $691.83	Professional		$194.98	$457.09	$691.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $117.49 / $223.87	Professional	26	$52.48	$117.49	$223.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $316.23 / $478.63	Professional	TC	$144.54	$316.23	$478.63
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $371.54 / $512.86	Professional		$309.03	$371.54	$512.86
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $123.03 / $158.49	Professional	26	$102.33	$123.03	$158.49
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $251.19 / $346.74	Professional	TC	$208.93	$251.19	$346.74
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $407.38 / $512.86 / $851.14	Facility	26	$407.38	$512.86	$851.14
Medica Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $478.63 / $1,905.46	Professional		$229.09	$478.63	$1,905.46
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $194.98 / $549.54	Professional	26	$67.61	$194.98	$549.54
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $331.13 / $1,584.89	Professional	TC	$154.88	$331.13	$1,584.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $309.03	Professional		$32.36	$33.11	$309.03
Quartz Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $426.58 / $1,122.02	Professional		$218.78	$426.58	$1,122.02
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $128.82 / $501.19 / $501.19	Facility	26	$128.82	$501.19	$501.19
Quartz Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $1,096.48 / $1,949.84	Professional		$257.04	$1,096.48	$1,949.84
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $309.03 / $446.68	Professional	26	$74.13	$309.03	$446.68
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $891.25 / $1,621.81	Professional	TC	$173.78	$891.25	$1,621.81
Security Health Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $977.24 / $1,445.44	Professional		$741.31	$977.24	$1,445.44
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $199.53 / $229.09 / $263.03	Professional	26	$199.53	$229.09	$263.03
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $407.38 / $575.44 / $724.44	Professional	TC	$407.38	$575.44	$724.44
United Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $354.81 / $741.31	Professional		$204.17	$354.81	$741.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $97.72 / $218.78	Professional	26	$63.10	$97.72	$218.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $257.04 / $562.34	Professional	TC	$134.90	$257.04	$562.34