Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $223.87 / $288.40 / $288.40	Facility	26	$223.87	$288.40	$288.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $630.96 / $1,862.09	Professional		$426.58	$630.96	$1,862.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $181.97 / $501.19	Professional	26	$107.15	$181.97	$501.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $436.52 / $891.25	Professional	TC	$302.00	$436.52	$891.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $758.58 / $2,754.23	Professional		$478.63	$758.58	$2,754.23
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $162.18 / $602.56	Professional	26	$104.71	$162.18	$602.56
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $371.54 / $616.60 / $2,187.76	Professional	TC	$371.54	$616.60	$2,187.76
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $281.84 / $331.13 / $524.81	Facility	26	$281.84	$331.13	$524.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $1,258.93 / $1,995.26	Professional		$512.86	$1,258.93	$1,995.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $229.09 / $436.52	Professional	26	$100.00	$229.09	$436.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $436.52 / $1,023.29 / $1,548.82	Professional	TC	$436.52	$1,023.29	$1,548.82
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,047.13 / $1,479.11	Professional		$870.96	$1,047.13	$1,479.11
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $194.98 / $234.42 / $316.23	Professional	26	$194.98	$234.42	$316.23
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $676.08 / $812.83 / $1,174.90	Professional	TC	$676.08	$812.83	$1,174.90
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $1,000.00 / $1,000.00 / $1,000.00	Facility	26	$1,000.00	$1,000.00	$1,000.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $1,348.96 / $6,025.60	Professional		$645.65	$1,348.96	$6,025.60
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $245.47 / $933.25	Professional	26	$114.82	$245.47	$933.25
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $512.86 / $1,071.52 / $5,370.32	Professional	TC	$512.86	$1,071.52	$5,370.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $870.96	Professional		$32.36	$33.11	$870.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $1,174.90 / $2,454.71	Professional		$602.56	$1,174.90	$2,454.71
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $251.19 / $977.24 / $977.24	Facility	26	$251.19	$977.24	$977.24
Quartz Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $3,388.44 / $6,165.95	Professional		$691.83	$3,388.44	$6,165.95
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $131.83 / $549.54 / $933.25	Professional	26	$131.83	$549.54	$933.25
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $549.54 / $3,019.95 / $5,623.41	Professional	TC	$549.54	$3,019.95	$5,623.41
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,137.96 / $3,019.95 / $4,168.69	Professional		$2,137.96	$3,019.95	$4,168.69
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $457.09 / $645.65 / $831.76	Professional	26	$457.09	$645.65	$831.76
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,659.59 / $2,754.23 / $3,388.44	Professional	TC	$1,659.59	$2,754.23	$3,388.44
United Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $1,023.29 / $2,187.76	Professional		$575.44	$1,023.29	$2,187.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $186.21 / $407.38	Professional	26	$114.82	$186.21	$407.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $457.09 / $812.83 / $1,862.09	Professional	TC	$457.09	$812.83	$1,862.09