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 / $359.87	Facility	26	$91.80	$98.82	$359.87
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 $45.18 / $79.38 / $409.34	Professional	26	$45.18	$79.38	$409.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $92.02 / $168.26 / $306.32	Professional	TC	$92.02	$168.26	$306.32
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $130.03 / $330.74 / $1,016.51	Professional		$130.03	$330.74	$1,016.51
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 / $654.91	Professional	TC	$84.13	$214.53	$654.91
CareSource Facility/Professional Professional Modifier Low / Median / High Price $52.45 / $101.49 / $179.43	Professional		$52.45	$101.49	$179.43
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 $190.11 / $468.45 / $532.33	Professional		$190.11	$468.45	$532.33
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 $122.04 / $302.87 / $344.18	Professional	TC	$122.04	$302.87	$344.18
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $442.24 / $442.24 / $442.24	Facility	26	$442.24	$442.24	$442.24
Medica Facility/Professional Professional Modifier Low / Median / High Price $180.59 / $453.28 / $1,609.32	Professional		$180.59	$453.28	$1,609.32
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $58.77 / $133.71 / $379.76	Professional	26	$58.77	$133.71	$379.76
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $121.38 / $325.94 / $1,318.35	Professional	TC	$121.38	$325.94	$1,318.35
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 $256.75 / $384.65 / $943.82	Professional		$256.75	$384.65	$943.82
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 $198.35 / $888.45 / $1,609.32	Professional		$198.35	$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 $127.56 / $708.03 / $1,318.35	Professional	TC	$127.56	$708.03	$1,318.35
Security Health Facility/Professional Professional Modifier Low / Median / High Price $584.49 / $834.70 / $835.38	Professional		$584.49	$834.70	$835.38
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $165.27 / $203.27 / $268.68	Professional	26	$165.27	$203.27	$268.68
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $304.51 / $452.56 / $912.19	Professional	TC	$304.51	$452.56	$912.19
United Facility/Professional Professional Modifier Low / Median / High Price $160.25 / $365.92 / $749.04	Professional		$160.25	$365.92	$749.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.87 / $116.86 / $216.23	Professional	26	$53.87	$116.86	$216.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $106.82 / $267.20 / $575.09	Professional	TC	$106.82	$267.20	$575.09