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 / $188.74	Facility	26	$147.02	$164.13	$188.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $207.87 / $494.18 / $2,281.50	Professional		$207.87	$494.18	$2,281.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.77 / $176.40 / $773.00	Professional	26	$71.77	$176.40	$773.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $135.04 / $295.64 / $485.75	Professional	TC	$135.04	$295.64	$485.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $191.58 / $483.03 / $1,510.14	Professional		$191.58	$483.03	$1,510.14
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $68.39 / $162.61 / $534.92	Professional	26	$68.39	$162.61	$534.92
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 / $148.10 / $263.61	Professional		$78.09	$148.10	$263.61
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 $279.14 / $688.30 / $782.16	Professional		$279.14	$688.30	$782.16
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 $177.86 / $442.79 / $532.74	Professional	TC	$177.86	$442.79	$532.74
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $656.72 / $656.72 / $1,672.00	Facility	26	$656.72	$656.72	$1,672.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $272.94 / $682.34 / $3,174.82	Professional		$272.94	$682.34	$3,174.82
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $87.82 / $208.38 / $609.25	Professional	26	$87.82	$208.38	$609.25
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $177.80 / $466.39 / $2,772.01	Professional	TC	$177.80	$466.39	$2,772.01
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 $377.65 / $565.78 / $2,035.41	Professional		$377.65	$565.78	$2,035.41
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 $297.41 / $1,738.31 / $3,174.82	Professional		$297.41	$1,738.31	$3,174.82
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $103.40 / $365.90 / $609.25	Professional	26	$103.40	$365.90	$609.25
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $189.32 / $1,488.67 / $2,772.01	Professional	TC	$189.32	$1,488.67	$2,772.01
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,215.13 / $1,226.48 / $1,767.15	Professional		$1,215.13	$1,226.48	$1,767.15
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $303.45 / $432.75 / $530.85	Professional	26	$303.45	$432.75	$530.85
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $697.22 / $880.65 / $1,712.46	Professional	TC	$697.22	$880.65	$1,712.46
United Facility/Professional Professional Modifier Low / Median / High Price $234.48 / $566.87 / $1,211.96	Professional		$234.48	$566.87	$1,211.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $83.09 / $182.95 / $320.72	Professional	26	$83.09	$182.95	$320.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $155.91 / $374.02 / $1,190.40	Professional	TC	$155.91	$374.02	$1,190.40