Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $363.08 / $676.08	Facility		$83.18	$363.08	$676.08
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.13 / $16.98 / $20.42	Facility	26	$14.13	$16.98	$20.42
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $38.02 / $251.19 / $524.81	Facility	TC	$38.02	$251.19	$524.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $50.12 / $141.25	Professional		$28.18	$50.12	$141.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $15.85 / $45.71	Professional	26	$8.91	$15.85	$45.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $32.36 / $93.33	Professional	TC	$19.05	$32.36	$93.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $48.98 / $169.82	Professional		$31.62	$48.98	$169.82
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $15.49 / $51.29	Professional	26	$9.55	$15.49	$51.29
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $34.67 / $117.49	Professional	TC	$22.39	$34.67	$117.49
CareSource Facility/Professional Facility Modifier Low / Median / High Price $13.49 / $33.88 / $52.48	Facility		$13.49	$33.88	$52.48
CareSource Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $28.18 / $41.69	Professional		$12.30	$28.18	$41.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $104.71 / $165.96	Facility		$89.13	$104.71	$165.96
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.12 / $29.51 / $46.77	Facility	26	$25.12	$29.51	$46.77
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $64.57 / $74.13 / $120.23	Facility	TC	$64.57	$74.13	$120.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $70.79 / $134.90	Professional		$33.11	$70.79	$134.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $21.88 / $39.81	Professional	26	$10.23	$21.88	$39.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $54.95 / $93.33	Professional	TC	$22.91	$54.95	$93.33
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $58.88 / $295.12	Facility		$30.20	$58.88	$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 $60.26 / $72.44 / $97.72	Professional		$60.26	$72.44	$97.72
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $21.38 / $29.51	Professional	26	$18.20	$21.38	$29.51
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $51.29 / $64.57	Professional	TC	$42.66	$51.29	$64.57
Medica Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $58.88 / $269.15	Facility		$30.20	$58.88	$269.15
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $151.36	Facility	26	$100.00	$100.00	$151.36
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $107.15 / $295.12 / $602.56	Facility	TC	$107.15	$295.12	$602.56
Medica Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $69.18 / $218.78	Professional		$33.11	$69.18	$218.78
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $23.44 / $87.10	Professional	26	$10.96	$23.44	$87.10
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $44.67 / $204.17	Professional	TC	$21.88	$44.67	$204.17
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 $43.65 / $85.11 / $208.93	Professional		$43.65	$85.11	$208.93
Quartz Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $363.08 / $363.08	Facility		$89.13	$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 / $147.91 / $147.91	Facility	TC	$100.00	$147.91	$147.91
Quartz Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $165.96 / $218.78	Professional		$41.69	$165.96	$218.78
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $52.48 / $87.10	Professional	26	$13.18	$52.48	$87.10
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $112.20 / $204.17	Professional	TC	$29.51	$112.20	$204.17
Security Health Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $147.91 / $204.17	Professional		$72.44	$147.91	$204.17
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $30.20 / $45.71	Professional	26	$24.55	$30.20	$45.71
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $58.88 / $102.33	Professional	TC	$47.86	$58.88	$102.33
United Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $275.42 / $363.08	Facility		$275.42	$275.42	$363.08
United Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $48.98 / $109.65	Professional		$32.36	$48.98	$109.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $15.85 / $35.48	Professional	26	$10.47	$15.85	$35.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $32.36 / $74.13	Professional	TC	$21.88	$32.36	$74.13