Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $165.96 / $190.55 / $281.84	Facility	26	$165.96	$190.55	$281.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $467.74 / $1,862.09	Professional		$251.19	$467.74	$1,862.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $93.33 / $407.38	Professional	26	$77.62	$93.33	$407.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $218.78 / $478.63	Professional	TC	$162.18	$218.78	$478.63
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $436.52 / $1,621.81	Professional		$281.84	$436.52	$1,621.81
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $128.82 / $489.78	Professional	26	$83.18	$128.82	$489.78
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $309.03 / $1,148.15	Professional	TC	$199.53	$309.03	$1,148.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $239.88 / $363.08	Professional		$109.65	$239.88	$363.08
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $223.87 / $263.03 / $416.87	Facility	26	$223.87	$263.03	$416.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $616.60 / $1,174.90	Professional		$295.12	$616.60	$1,174.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $177.83 / $346.74	Professional	26	$79.43	$177.83	$346.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $446.68 / $831.76	Professional	TC	$213.80	$446.68	$831.76
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $630.96 / $851.14	Professional		$524.81	$630.96	$851.14
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $158.49 / $190.55 / $257.04	Professional	26	$158.49	$190.55	$257.04
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $371.54 / $446.68 / $602.56	Professional	TC	$371.54	$446.68	$602.56
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $575.44 / $812.83 / $812.83	Facility	26	$575.44	$812.83	$812.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $724.44 / $3,162.28	Professional		$354.81	$724.44	$3,162.28
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $288.40 / $1,000.00	Professional	26	$104.71	$288.40	$1,000.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $537.03 / $2,691.53	Professional	TC	$245.47	$537.03	$2,691.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $467.74	Professional		$32.36	$33.11	$467.74
Quartz Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $707.95 / $1,258.93	Professional		$363.08	$707.95	$1,258.93
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $199.53 / $794.33 / $794.33	Facility	26	$199.53	$794.33	$794.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $1,819.70 / $3,311.31	Professional		$389.05	$1,819.70	$3,311.31
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $446.68 / $1,000.00	Professional	26	$107.15	$446.68	$1,000.00
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $1,513.56 / $2,754.23	Professional	TC	$275.42	$1,513.56	$2,754.23
Security Health Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,380.38 / $2,089.30	Professional		$977.24	$1,380.38	$2,089.30
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $269.15 / $302.00 / $407.38	Professional	26	$269.15	$302.00	$407.38
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $660.69 / $741.31 / $977.24	Professional	TC	$660.69	$741.31	$977.24
United Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $537.03 / $1,174.90	Professional		$309.03	$537.03	$1,174.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $144.54 / $323.59	Professional	26	$93.33	$144.54	$323.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $389.05 / $891.25	Professional	TC	$213.80	$389.05	$891.25