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 / $229.09	Facility	26	$147.91	$190.55	$229.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $457.09 / $1,737.80	Professional		$199.53	$457.09	$1,737.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $125.89 / $407.38	Professional	26	$66.07	$125.89	$407.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $245.47 / $616.60	Professional	TC	$123.03	$245.47	$616.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $389.05 / $1,122.02	Professional		$190.55	$389.05	$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 / $562.34	Professional	TC	$151.36	$407.38	$562.34
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $426.58 / $588.84	Professional		$354.81	$426.58	$588.84
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 / $275.42 / $380.19	Professional	TC	$229.09	$275.42	$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 / $616.60 / $3,162.28	Professional		$251.19	$616.60	$3,162.28
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $177.83 / $602.56	Professional	26	$77.62	$177.83	$602.56
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $436.52 / $2,754.23	Professional	TC	$165.96	$436.52	$2,754.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $478.63	Professional		$32.36	$33.11	$478.63
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 $295.12 / $1,819.70 / $3,235.94	Professional		$295.12	$1,819.70	$3,235.94
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $363.08 / $602.56	Professional	26	$91.20	$363.08	$602.56
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $1,548.82 / $2,884.03	Professional	TC	$190.55	$1,548.82	$2,884.03
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,318.26 / $1,862.09	Professional		$1,174.90	$1,318.26	$1,862.09
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $302.00 / $436.52 / $549.54	Professional	26	$302.00	$436.52	$549.54
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $645.65 / $954.99 / $1,445.44	Professional	TC	$645.65	$954.99	$1,445.44
United Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $446.68 / $1,023.29	Professional		$223.87	$446.68	$1,023.29
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 / $812.83	Professional	TC	$147.91	$309.03	$812.83