Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $68.67 / $379.95 / $680.40	Facility		$68.67	$379.95	$680.40
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.66 / $16.85 / $20.36	Facility	26	$14.66	$16.85	$20.36
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $34.60 / $395.00 / $525.54	Facility	TC	$34.60	$395.00	$525.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.73 / $49.28 / $210.02	Professional		$30.73	$49.28	$210.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.27 / $14.91 / $89.25	Professional	26	$9.27	$14.91	$89.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.09 / $34.60 / $116.85	Professional	TC	$20.09	$34.60	$116.85
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.78 / $67.47 / $195.45	Professional		$31.78	$67.47	$195.45
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.46 / $21.85 / $60.87	Professional	26	$9.46	$21.85	$60.87
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.99 / $45.62 / $126.04	Professional	TC	$21.99	$45.62	$126.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10.08 / $26.87 / $40.46	Facility		$10.08	$26.87	$40.46
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.81 / $27.90 / $44.63	Professional		$10.81	$27.90	$44.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.21 / $104.25 / $138.56	Facility		$89.21	$104.25	$138.56
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.23 / $29.48 / $39.19	Facility	26	$25.23	$29.48	$39.19
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $63.98 / $74.77 / $99.37	Facility	TC	$63.98	$74.77	$99.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.89 / $115.60 / $131.36	Professional		$39.89	$115.60	$131.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.20 / $34.29 / $38.97	Professional	26	$12.20	$34.29	$38.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.09 / $81.29 / $92.38	Professional	TC	$28.09	$81.29	$92.38
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $28.66 / $49.26 / $68.45	Facility		$28.66	$49.26	$68.45
Medica Facility/Professional Facility Modifier Low / Median / High Price $28.66 / $56.91 / $271.91	Facility		$28.66	$56.91	$271.91
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $152.00	Facility	26	$100.00	$100.00	$152.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $105.96 / $277.45 / $597.39	Facility	TC	$105.96	$277.45	$597.39
Medica Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $79.08 / $218.00	Professional		$33.88	$79.08	$218.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $11.49 / $27.29 / $87.52	Professional	26	$11.49	$27.29	$87.52
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $53.70 / $206.00	Professional	TC	$22.39	$53.70	$206.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.34 / $36.29 / $73.76	Professional		$19.34	$36.29	$73.76
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $28.66 / $49.26 / $68.45	Facility		$28.66	$49.26	$68.45
Quartz Facility/Professional Professional Modifier Low / Median / High Price $64.34 / $96.41 / $206.73	Professional		$64.34	$96.41	$206.73
Quartz Facility/Professional Facility Modifier Low / Median / High Price $88.40 / $342.77 / $342.77	Facility		$88.40	$342.77	$342.77
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 / $105.96 / $105.96	Facility	TC	$100.00	$105.96	$105.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $53.55 / $152.00 / $218.00	Professional		$53.55	$152.00	$218.00
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $15.88 / $50.35 / $87.52	Professional	26	$15.88	$50.35	$87.52
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $37.10 / $101.60 / $206.00	Professional	TC	$37.10	$101.60	$206.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $73.19 / $191.72 / $205.93	Professional		$73.19	$191.72	$205.93
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $24.78 / $31.35 / $61.03	Professional	26	$24.78	$31.35	$61.03
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $48.41 / $60.69 / $130.69	Professional	TC	$48.41	$60.69	$130.69
United Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $71.39 / $133.40	Professional		$33.88	$71.39	$133.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.18 / $22.99 / $44.13	Professional	26	$11.18	$22.99	$44.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.22 / $47.74 / $89.21	Professional	TC	$22.22	$47.74	$89.21