Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $354.81 / $676.08	Facility		$186.21	$354.81	$676.08
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.85 / $18.62 / $22.39	Facility	26	$15.85	$18.62	$22.39
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $48.98 / $281.84 / $407.38	Facility	TC	$48.98	$281.84	$407.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $58.88 / $181.97	Professional		$33.88	$58.88	$181.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $19.05 / $61.66	Professional	26	$10.00	$19.05	$61.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $39.81 / $112.20	Professional	TC	$22.91	$39.81	$112.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $58.88 / $194.98	Professional		$36.31	$58.88	$194.98
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $16.22 / $56.23	Professional	26	$10.47	$16.22	$56.23
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $41.69 / $134.90	Professional	TC	$24.55	$41.69	$134.90
CareSource Facility/Professional Facility Modifier Low / Median / High Price $15.14 / $41.69 / $61.66	Facility		$15.14	$41.69	$61.66
CareSource Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $34.67 / $50.12	Professional		$13.49	$34.67	$50.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $125.89 / $199.53	Facility		$107.15	$125.89	$199.53
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.18 / $32.36 / $52.48	Facility	26	$28.18	$32.36	$52.48
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $79.43 / $93.33 / $147.91	Facility	TC	$79.43	$93.33	$147.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $85.11 / $162.18	Professional		$38.02	$85.11	$162.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $22.91 / $43.65	Professional	26	$11.22	$22.91	$43.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $61.66 / $117.49	Professional	TC	$26.30	$61.66	$117.49
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $61.66 / $295.12	Facility		$33.88	$61.66	$295.12
DeanCare Facility/Professional Facility Modifier TC Low / Median / High Price $223.87 / $269.15 / $354.81	Facility	TC	$223.87	$269.15	$354.81
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $87.10 / $117.49	Professional		$72.44	$87.10	$117.49
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $23.99 / $32.36	Professional	26	$19.95	$23.99	$32.36
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $60.26 / $81.28	Professional	TC	$53.70	$60.26	$81.28
Medica Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $69.18 / $316.23	Facility		$33.88	$69.18	$316.23
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $199.53	Facility	26	$100.00	$100.00	$199.53
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $131.83 / $281.84 / $501.19	Facility	TC	$131.83	$281.84	$501.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $83.18 / $257.04	Professional		$38.02	$83.18	$257.04
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $28.84 / $91.20	Professional	26	$11.75	$28.84	$91.20
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $52.48 / $194.98	Professional	TC	$26.30	$52.48	$194.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $70.79	Professional		$32.36	$33.11	$70.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $100.00 / $199.53	Professional		$52.48	$100.00	$199.53
Quartz Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $363.08 / $363.08	Facility		$95.50	$363.08	$363.08
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Quartz Facility/Professional Facility Modifier TC Low / Median / High Price $100.00 / $186.21 / $186.21	Facility	TC	$100.00	$186.21	$186.21
Quartz Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $181.97 / $257.04	Professional		$39.81	$181.97	$257.04
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $56.23 / $91.20	Professional	26	$13.18	$56.23	$91.20
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $125.89 / $194.98	Professional	TC	$28.18	$125.89	$194.98
Security Health Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $177.83 / $245.47	Professional		$70.79	$177.83	$245.47
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $29.51 / $51.29	Professional	26	$24.55	$29.51	$51.29
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $57.54 / $128.82	Professional	TC	$45.71	$57.54	$128.82
United Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $229.09 / $302.00	Facility		$229.09	$229.09	$302.00
United Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $53.70 / $131.83	Professional		$36.31	$53.70	$131.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $16.98 / $38.02	Professional	26	$11.22	$16.98	$38.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $38.02 / $89.13	Professional	TC	$25.70	$38.02	$89.13