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 / $105.56	Facility	26	$91.80	$98.82	$105.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $140.40 / $258.77 / $896.36	Professional		$140.40	$258.77	$896.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.14 / $87.82 / $527.00	Professional	26	$44.14	$87.82	$527.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $91.32 / $166.97 / $306.32	Professional	TC	$91.32	$166.97	$306.32
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $129.38 / $329.94 / $1,014.00	Professional		$129.38	$329.94	$1,014.00
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 $83.49 / $212.89 / $652.40	Professional	TC	$83.49	$212.89	$652.40
CareSource Facility/Professional Professional Modifier Low / Median / High Price $52.45 / $101.10 / $178.98	Professional		$52.45	$101.10	$178.98
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 $189.63 / $466.09 / $529.65	Professional		$189.63	$466.09	$529.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.24 / $165.57 / $188.15	Professional	26	$63.24	$165.57	$188.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $121.56 / $300.52 / $341.50	Professional	TC	$121.56	$300.52	$341.50
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $348.65 / $442.24 / $442.24	Facility	26	$348.65	$442.24	$442.24
Medica Facility/Professional Professional Modifier Low / Median / High Price $179.77 / $468.86 / $1,609.32	Professional		$179.77	$468.86	$1,609.32
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $58.77 / $144.69 / $379.76	Professional	26	$58.77	$144.69	$379.76
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $120.56 / $323.47 / $1,345.00	Professional	TC	$120.56	$323.47	$1,345.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $56.22 / $106.43 / $253.57	Professional		$56.22	$106.43	$253.57
Quartz Facility/Professional Professional Modifier Low / Median / High Price $256.10 / $383.68 / $1,003.67	Professional		$256.10	$383.68	$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 $197.78 / $888.45 / $1,609.32	Professional		$197.78	$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 $129.09 / $708.03 / $1,345.00	Professional	TC	$129.09	$708.03	$1,345.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $582.21 / $830.50 / $835.38	Professional		$582.21	$830.50	$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 $302.14 / $450.09 / $908.44	Professional	TC	$302.14	$450.09	$908.44
United Facility/Professional Professional Modifier Low / Median / High Price $159.53 / $389.70 / $745.66	Professional		$159.53	$389.70	$745.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.92 / $116.86 / $216.23	Professional	26	$55.92	$116.86	$216.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $106.10 / $265.39 / $575.09	Professional	TC	$106.10	$265.39	$575.09