Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $167.33 / $180.14 / $192.42	Facility	26	$167.33	$180.14	$192.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $276.27 / $508.57 / $1,893.33	Professional		$276.27	$508.57	$1,893.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $80.06 / $158.00 / $751.12	Professional	26	$80.06	$158.00	$751.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $170.48 / $341.24 / $589.98	Professional	TC	$170.48	$341.24	$589.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $281.75 / $656.48 / $2,206.87	Professional		$281.75	$656.48	$2,206.87
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $83.66 / $198.92 / $656.71	Professional	26	$83.66	$198.92	$656.71
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $198.09 / $463.43 / $1,531.57	Professional	TC	$198.09	$463.43	$1,531.57
CareSource Facility/Professional Professional Modifier Low / Median / High Price $95.78 / $239.64 / $388.41	Professional		$95.78	$239.64	$388.41
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $225.28 / $263.26 / $349.89	Facility	26	$225.28	$263.26	$349.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $390.00 / $1,014.88 / $1,153.28	Professional		$390.00	$1,014.88	$1,153.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.68 / $300.85 / $341.88	Professional	26	$102.68	$300.85	$341.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $273.00 / $714.02 / $811.39	Professional	TC	$273.00	$714.02	$811.39
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $578.00 / $804.96 / $804.96	Facility	26	$578.00	$804.96	$804.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $351.60 / $869.61 / $3,183.14	Professional		$351.60	$869.61	$3,183.14
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $107.62 / $287.52 / $1,009.00	Professional	26	$107.62	$287.52	$1,009.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $243.98 / $636.33 / $2,699.58	Professional	TC	$243.98	$636.33	$2,699.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $80.83 / $188.32 / $483.77	Professional		$80.83	$188.32	$483.77
Quartz Facility/Professional Professional Modifier Low / Median / High Price $558.35 / $836.49 / $1,227.18	Professional		$558.35	$836.49	$1,227.18
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $204.38 / $804.96 / $804.96	Facility	26	$204.38	$804.96	$804.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $427.44 / $1,753.05 / $3,183.14	Professional		$427.44	$1,753.05	$3,183.14
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $126.72 / $448.40 / $1,009.00	Professional	26	$126.72	$448.40	$1,009.00
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $300.72 / $1,453.51 / $2,699.58	Professional	TC	$300.72	$1,453.51	$2,699.58
Security Health Facility/Professional Professional Modifier Low / Median / High Price $972.48 / $1,649.60 / $1,649.60	Professional		$972.48	$1,649.60	$1,649.60
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $273.11 / $301.04 / $517.10	Professional	26	$273.11	$301.04	$517.10
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $671.44 / $758.63 / $1,750.03	Professional	TC	$671.44	$758.63	$1,750.03
United Facility/Professional Professional Modifier Low / Median / High Price $340.09 / $732.50 / $1,458.37	Professional		$340.09	$732.50	$1,458.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $97.89 / $209.50 / $393.02	Professional	26	$97.89	$209.50	$393.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $223.58 / $528.89 / $1,148.84	Professional	TC	$223.58	$528.89	$1,148.84