Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $147.02 / $164.13 / $229.78	Facility	26	$147.02	$164.13	$229.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $207.87 / $506.66 / $2,269.50	Professional		$207.87	$506.66	$2,269.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.77 / $189.00 / $807.50	Professional	26	$71.77	$189.00	$807.50
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $101.43 / $176.34 / $359.01	Professional	52	$101.43	$176.34	$359.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $135.04 / $309.77 / $834.71	Professional	TC	$135.04	$309.77	$834.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $191.58 / $460.24 / $1,512.65	Professional		$191.58	$460.24	$1,512.65
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $68.39 / $162.61 / $537.44	Professional	26	$68.39	$162.61	$537.44
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $123.19 / $318.85 / $975.21	Professional	TC	$123.19	$318.85	$975.21
CareSource Facility/Professional Professional Modifier Low / Median / High Price $78.09 / $147.69 / $263.16	Professional		$78.09	$147.69	$263.16
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $182.93 / $213.77 / $284.11	Facility	26	$182.93	$213.77	$284.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $278.66 / $689.48 / $783.50	Professional		$278.66	$689.48	$783.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.23 / $245.50 / $278.98	Professional	26	$87.23	$245.50	$278.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $177.38 / $443.97 / $504.51	Professional	TC	$177.38	$443.97	$504.51
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $656.72 / $656.72 / $1,659.75	Facility	26	$656.72	$656.72	$1,659.75
Medica Facility/Professional Professional Modifier Low / Median / High Price $272.94 / $702.56 / $2,901.82	Professional		$272.94	$702.56	$2,901.82
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $87.82 / $220.44 / $608.04	Professional	26	$87.82	$220.44	$608.04
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $177.80 / $466.39 / $2,498.98	Professional	TC	$177.80	$466.39	$2,498.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.30 / $126.15 / $308.19	Professional		$54.30	$126.15	$308.19
Quartz Facility/Professional Professional Modifier Low / Median / High Price $377.00 / $564.79 / $2,051.16	Professional		$377.00	$564.79	$2,051.16
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $166.78 / $656.72 / $656.72	Facility	26	$166.78	$656.72	$656.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $327.86 / $1,590.80 / $2,901.82	Professional		$327.86	$1,590.80	$2,901.82
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $103.40 / $365.90 / $558.07	Professional	26	$103.40	$365.90	$558.07
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $188.82 / $1,341.18 / $2,498.98	Professional	TC	$188.82	$1,341.18	$2,498.98
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,222.86 / $2,674.95 / $2,674.95	Professional		$1,222.86	$2,674.95	$2,674.95
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $321.30 / $911.00 / $911.00	Professional	26	$321.30	$911.00	$911.00
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $810.93 / $1,763.93 / $1,763.93	Professional	TC	$810.93	$1,763.93	$1,763.93
United Facility/Professional Professional Modifier Low / Median / High Price $239.34 / $581.55 / $1,178.47	Professional		$239.34	$581.55	$1,178.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $83.09 / $186.06 / $320.72	Professional	26	$83.09	$186.06	$320.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $155.91 / $374.02 / $1,078.14	Professional	TC	$155.91	$374.02	$1,078.14