Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $147.91 / $190.55 / $281.84	Facility	26	$147.91	$190.55	$281.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $478.63 / $1,862.09	Professional		$208.93	$478.63	$1,862.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $125.89 / $478.63	Professional	26	$67.61	$125.89	$478.63
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $141.25 / $512.86 / $549.54	Professional	52	$141.25	$512.86	$549.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $257.04 / $676.08	Professional	TC	$125.89	$257.04	$676.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $380.19 / $1,122.02	Professional		$190.55	$380.19	$1,122.02
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $107.15 / $398.11	Professional	26	$67.61	$107.15	$398.11
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $251.19 / $776.25	Professional	TC	$123.03	$251.19	$776.25
CareSource Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $147.91 / $245.47	Professional		$89.13	$147.91	$245.47
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $181.97 / $213.80 / $338.84	Facility	26	$181.97	$213.80	$338.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $588.84 / $794.33	Professional		$223.87	$588.84	$794.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $158.49 / $281.84	Professional	26	$64.57	$158.49	$281.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $407.38 / $524.81	Professional	TC	$151.36	$407.38	$524.81
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $426.58 / $575.44	Professional		$354.81	$426.58	$575.44
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $154.88 / $208.93	Professional	26	$128.82	$154.88	$208.93
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $269.15 / $380.19	Professional	TC	$229.09	$269.15	$380.19
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $660.69 / $660.69 / $1,659.59	Facility	26	$660.69	$660.69	$1,659.59
Medica Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $645.65 / $2,884.03	Professional		$251.19	$645.65	$2,884.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $199.53 / $630.96	Professional	26	$83.18	$199.53	$630.96
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $426.58 / $2,511.89	Professional	TC	$165.96	$426.58	$2,511.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $467.74	Professional		$32.36	$33.11	$467.74
Quartz Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $489.78 / $2,041.74	Professional		$251.19	$489.78	$2,041.74
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $162.18 / $645.65 / $645.65	Facility	26	$162.18	$645.65	$645.65
Quartz Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $1,659.59 / $3,019.95	Professional		$309.03	$1,659.59	$3,019.95
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $363.08 / $562.34	Professional	26	$91.20	$363.08	$562.34
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $1,412.54 / $2,570.40	Professional	TC	$190.55	$1,412.54	$2,570.40
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,659.59 / $2,691.53	Professional		$1,258.93	$1,659.59	$2,691.53
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $302.00 / $446.68 / $912.01	Professional	26	$302.00	$446.68	$912.01
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $812.83 / $1,380.38 / $1,778.28	Professional	TC	$812.83	$1,380.38	$1,778.28
United Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $446.68 / $933.25	Professional		$223.87	$446.68	$933.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $125.89 / $269.15	Professional	26	$75.86	$125.89	$269.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $309.03 / $794.33	Professional	TC	$147.91	$309.03	$794.33