Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $114.82 / $114.82 / $123.03	Facility	26	$114.82	$114.82	$123.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $281.84 / $602.56	Professional		$194.98	$281.84	$602.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $85.11 / $208.93	Professional	26	$56.23	$85.11	$208.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $208.93 / $371.54	Professional	TC	$134.90	$208.93	$371.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $346.74 / $1,148.15	Professional		$194.98	$346.74	$1,148.15
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $95.50 / $338.84	Professional	26	$57.54	$95.50	$338.84
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $275.42 / $812.83	Professional	TC	$138.04	$275.42	$812.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $165.96 / $245.47	Professional		$75.86	$165.96	$245.47
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $154.88 / $181.97 / $288.40	Facility	26	$154.88	$181.97	$288.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $524.81 / $812.83	Professional		$234.42	$524.81	$812.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $131.83 / $239.88	Professional	26	$57.54	$131.83	$239.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $389.05 / $575.44	Professional	TC	$181.97	$389.05	$575.44
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $436.52 / $602.56	Professional		$363.08	$436.52	$602.56
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $131.83 / $177.83	Professional	26	$107.15	$131.83	$177.83
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $309.03 / $426.58	Professional	TC	$257.04	$309.03	$426.58
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $549.54 / $549.54 / $549.54	Facility	26	$549.54	$549.54	$549.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $562.34 / $2,344.23	Professional		$269.15	$562.34	$2,344.23
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $144.54 / $537.03	Professional	26	$70.79	$144.54	$537.03
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $407.38 / $1,995.26	Professional	TC	$186.21	$407.38	$1,995.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $389.05	Professional		$32.36	$33.11	$389.05
Quartz Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $501.19 / $1,380.38	Professional		$257.04	$501.19	$1,380.38
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $138.04 / $537.03 / $537.03	Facility	26	$138.04	$537.03	$537.03
Quartz Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $1,348.96 / $2,398.83	Professional		$302.00	$1,348.96	$2,398.83
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $338.84 / $537.03	Professional	26	$81.28	$338.84	$537.03
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $1,122.02 / $2,041.74	Professional	TC	$213.80	$1,122.02	$2,041.74
Security Health Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,202.26 / $1,698.24	Professional		$891.25	$1,202.26	$1,698.24
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $213.80 / $251.19 / $295.12	Professional	26	$213.80	$251.19	$295.12
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $501.19 / $707.95 / $912.01	Professional	TC	$501.19	$707.95	$912.01
United Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $416.87 / $870.96	Professional		$239.88	$416.87	$870.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $107.15 / $234.42	Professional	26	$69.18	$107.15	$234.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $316.23 / $691.83	Professional	TC	$165.96	$316.23	$691.83