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 / $578.13	Facility	26	$147.02	$164.13	$578.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $208.99 / $532.00 / $2,278.00	Professional		$208.99	$532.00	$2,278.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $68.39 / $187.01 / $807.46	Professional	26	$68.39	$187.01	$807.46
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $101.76 / $158.49 / $304.49	Professional	52	$101.76	$158.49	$304.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $129.40 / $335.00 / $872.61	Professional	TC	$129.40	$335.00	$872.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $192.22 / $480.72 / $1,515.17	Professional		$192.22	$480.72	$1,515.17
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 $123.83 / $318.83 / $977.72	Professional	TC	$123.83	$318.83	$977.72
CareSource Facility/Professional Professional Modifier Low / Median / High Price $78.09 / $148.49 / $264.05	Professional		$78.09	$148.49	$264.05
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $183.83 / $214.82 / $285.51	Facility	26	$183.83	$214.82	$285.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $279.62 / $691.83 / $786.18	Professional		$279.62	$691.83	$786.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.08 / $246.69 / $280.33	Professional	26	$81.08	$246.69	$280.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $178.34 / $445.15 / $532.74	Professional	TC	$178.34	$445.15	$532.74
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $659.84 / $659.84 / $1,647.50	Facility	26	$659.84	$659.84	$1,647.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $273.38 / $717.09 / $3,145.84	Professional		$273.38	$717.09	$3,145.84
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $87.82 / $229.03 / $728.40	Professional	26	$87.82	$229.03	$728.40
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $177.23 / $467.55 / $2,772.01	Professional	TC	$177.23	$467.55	$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 $378.30 / $566.75 / $2,061.42	Professional		$378.30	$566.75	$2,061.42
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $167.58 / $659.84 / $659.84	Facility	26	$167.58	$659.84	$659.84
Quartz Facility/Professional Professional Modifier Low / Median / High Price $328.98 / $1,720.15 / $3,145.84	Professional		$328.98	$1,720.15	$3,145.84
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $103.90 / $365.90 / $577.89	Professional	26	$103.90	$365.90	$577.89
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $189.83 / $1,488.67 / $2,772.01	Professional	TC	$189.83	$1,488.67	$2,772.01
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,219.00 / $2,662.19 / $2,662.19	Professional		$1,219.00	$2,662.19	$2,662.19
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $321.30 / $915.27 / $915.27	Professional	26	$321.30	$915.27	$915.27
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $805.16 / $1,746.92 / $1,746.92	Professional	TC	$805.16	$1,746.92	$1,746.92
United Facility/Professional Professional Modifier Low / Median / High Price $252.35 / $583.60 / $2,134.07	Professional		$252.35	$583.60	$2,134.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $83.48 / $186.06 / $320.72	Professional	26	$83.48	$186.06	$320.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $156.30 / $370.19 / $1,188.38	Professional	TC	$156.30	$370.19	$1,188.38