Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.20 / $104.71 / $363.08	Facility	26	$91.20	$104.71	$363.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $245.47 / $512.86	Professional		$134.90	$245.47	$512.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $67.61 / $186.21	Professional	26	$42.66	$67.61	$186.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $128.82 / $288.40	Professional	TC	$83.18	$128.82	$288.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $245.47 / $758.58	Professional		$128.82	$245.47	$758.58
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $70.79 / $269.15	Professional	26	$45.71	$70.79	$269.15
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $177.83 / $512.86	Professional	TC	$83.18	$177.83	$512.86
CareSource Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $102.33 / $169.82	Professional		$60.26	$102.33	$169.82
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $123.03 / $144.54 / $234.42	Facility	26	$123.03	$144.54	$234.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $354.81 / $537.03	Professional		$154.88	$354.81	$537.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $97.72 / $190.55	Professional	26	$43.65	$97.72	$190.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $251.19 / $354.81	Professional	TC	$114.82	$251.19	$354.81
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $288.40 / $457.09	Professional		$245.47	$288.40	$457.09
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $104.71 / $141.25	Professional	26	$87.10	$104.71	$141.25
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $186.21 / $331.13	Professional	TC	$154.88	$186.21	$331.13
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $446.68 / $446.68 / $446.68	Facility	26	$446.68	$446.68	$446.68
Medica Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $380.19 / $1,621.81	Professional		$181.97	$380.19	$1,621.81
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $114.82 / $380.19	Professional	26	$53.70	$114.82	$380.19
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $263.03 / $1,318.26	Professional	TC	$120.23	$263.03	$1,318.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $245.47	Professional		$32.36	$33.11	$245.47
Quartz Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $331.13 / $933.25	Professional		$169.82	$331.13	$933.25
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $109.65 / $426.58 / $426.58	Facility	26	$109.65	$426.58	$426.58
Quartz Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $933.25 / $1,659.59	Professional		$199.53	$933.25	$1,659.59
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $245.47 / $380.19	Professional	26	$66.07	$245.47	$380.19
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $741.31 / $1,348.96	Professional	TC	$134.90	$741.31	$1,348.96
Security Health Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $831.76 / $1,122.02	Professional		$588.84	$831.76	$1,122.02
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $165.96 / $194.98 / $229.09	Professional	26	$165.96	$194.98	$229.09
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $457.09 / $616.60	Professional	TC	$302.00	$457.09	$616.60
United Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $281.84 / $616.60	Professional		$158.49	$281.84	$616.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $79.43 / $177.83	Professional	26	$51.29	$79.43	$177.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $204.17 / $457.09	Professional	TC	$102.33	$204.17	$457.09