Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $114.97 / $123.77 / $123.77	Facility	26	$114.97	$123.77	$123.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $196.69 / $389.06 / $554.76	Professional		$196.69	$389.06	$554.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.85 / $90.03 / $544.98	Professional	26	$58.85	$90.03	$544.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $137.84 / $279.22 / $417.78	Professional	TC	$137.84	$279.22	$417.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $197.09 / $502.58 / $1,551.07	Professional		$197.09	$502.58	$1,551.07
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.48 / $139.94 / $452.59	Professional	26	$57.48	$139.94	$452.59
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $139.61 / $356.00 / $1,098.49	Professional	TC	$139.61	$356.00	$1,098.49
CareSource Facility/Professional Professional Modifier Low / Median / High Price $65.75 / $167.59 / $270.11	Professional		$65.75	$167.59	$270.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $154.99 / $181.12 / $240.73	Facility	26	$154.99	$181.12	$240.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $286.63 / $708.54 / $805.16	Professional		$286.63	$708.54	$805.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.03 / $207.15 / $235.40	Professional	26	$75.03	$207.15	$235.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $201.37 / $501.42 / $569.79	Professional	TC	$201.37	$501.42	$569.79
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $553.04 / $553.04 / $553.04	Facility	26	$553.04	$553.04	$553.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $269.52 / $676.50 / $2,319.03	Professional		$269.52	$676.50	$2,319.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $77.53 / $179.48 / $543.21	Professional	26	$77.53	$179.48	$543.21
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $187.96 / $509.05 / $1,973.17	Professional	TC	$187.96	$509.05	$1,973.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.40 / $157.40 / $377.33	Professional		$58.40	$157.40	$377.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $388.05 / $581.36 / $1,376.12	Professional		$388.05	$581.36	$1,376.12
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $140.72 / $553.04 / $553.04	Facility	26	$140.72	$553.04	$553.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $301.27 / $1,274.23 / $2,319.03	Professional		$301.27	$1,274.23	$2,319.03
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $87.25 / $339.85 / $543.21	Professional	26	$87.25	$339.85	$543.21
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $214.13 / $1,059.78 / $1,973.17	Professional	TC	$214.13	$1,059.78	$1,973.17
Security Health Facility/Professional Professional Modifier Low / Median / High Price $889.59 / $1,262.55 / $1,262.55	Professional		$889.59	$1,262.55	$1,262.55
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $208.27 / $264.00 / $371.47	Professional	26	$208.27	$264.00	$371.47
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $504.13 / $714.35 / $1,415.66	Professional	TC	$504.13	$714.35	$1,415.66
United Facility/Professional Professional Modifier Low / Median / High Price $241.27 / $561.50 / $1,117.92	Professional		$241.27	$561.50	$1,117.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $69.90 / $155.65 / $297.88	Professional	26	$69.90	$155.65	$297.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $171.37 / $413.75 / $873.04	Professional	TC	$171.37	$413.75	$873.04