Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.80 / $98.82 / $128.51	Facility	26	$91.80	$98.82	$128.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $141.11 / $260.06 / $762.27	Professional		$141.11	$260.06	$762.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.14 / $80.03 / $544.00	Professional	26	$44.14	$80.03	$544.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.05 / $168.26 / $306.32	Professional	TC	$83.05	$168.26	$306.32
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $130.03 / $331.54 / $1,019.01	Professional		$130.03	$331.54	$1,019.01
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.90 / $109.13 / $361.60	Professional	26	$45.90	$109.13	$361.60
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $84.13 / $214.53 / $657.43	Professional	TC	$84.13	$214.53	$657.43
CareSource Facility/Professional Professional Modifier Low / Median / High Price $52.45 / $101.90 / $179.88	Professional		$52.45	$101.90	$179.88
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $124.35 / $145.32 / $193.14	Facility	26	$124.35	$145.32	$193.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.59 / $469.62 / $533.66	Professional		$190.59	$469.62	$533.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.84 / $165.57 / $188.15	Professional	26	$62.84	$165.57	$188.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $122.52 / $304.05 / $345.51	Professional	TC	$122.52	$304.05	$345.51
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $352.45 / $442.24 / $966.67	Facility	26	$352.45	$442.24	$966.67
Medica Facility/Professional Professional Modifier Low / Median / High Price $180.59 / $470.99 / $1,609.32	Professional		$180.59	$470.99	$1,609.32
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $59.21 / $159.57 / $443.70	Professional	26	$59.21	$159.57	$443.70
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $121.38 / $325.94 / $1,331.00	Professional	TC	$121.38	$325.94	$1,331.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $56.22 / $105.44 / $253.57	Professional		$56.22	$105.44	$253.57
Quartz Facility/Professional Professional Modifier Low / Median / High Price $257.39 / $385.62 / $1,003.67	Professional		$257.39	$385.62	$1,003.67
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $112.48 / $442.24 / $442.24	Facility	26	$112.48	$442.24	$442.24
Quartz Facility/Professional Professional Modifier Low / Median / High Price $201.41 / $888.45 / $1,609.32	Professional		$201.41	$888.45	$1,609.32
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $69.73 / $246.70 / $379.76	Professional	26	$69.73	$246.70	$379.76
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $130.10 / $708.03 / $1,331.00	Professional	TC	$130.10	$708.03	$1,331.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $598.59 / $836.77 / $836.77	Professional		$598.59	$836.77	$836.77
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $166.46 / $206.35 / $288.01	Professional	26	$166.46	$206.35	$288.01
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $305.69 / $455.03 / $917.82	Professional	TC	$305.69	$455.03	$917.82
United Facility/Professional Professional Modifier Low / Median / High Price $160.25 / $389.33 / $749.04	Professional		$160.25	$389.33	$749.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.93 / $119.97 / $216.23	Professional	26	$53.93	$119.97	$216.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $106.38 / $256.79 / $575.09	Professional	TC	$106.38	$256.79	$575.09