Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $227.61 / $253.44 / $291.45	Facility	26	$227.61	$253.44	$291.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $350.64 / $774.44 / $3,750.30	Professional		$350.64	$774.44	$3,750.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $114.44 / $288.35 / $1,253.02	Professional	26	$114.44	$288.35	$1,253.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $238.22 / $375.25 / $931.29	Professional	TC	$238.22	$375.25	$931.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $322.68 / $779.63 / $2,546.48	Professional		$322.68	$779.63	$2,546.48
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $105.60 / $251.09 / $826.59	Professional	26	$105.60	$251.09	$826.59
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $217.08 / $535.91 / $1,719.89	Professional	TC	$217.08	$535.91	$1,719.89
CareSource Facility/Professional Professional Modifier Low / Median / High Price $121.04 / $258.33 / $441.00	Professional		$121.04	$258.33	$441.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $284.75 / $332.76 / $442.26	Facility	26	$284.75	$332.76	$442.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $467.25 / $1,157.67 / $1,315.54	Professional		$467.25	$1,157.67	$1,315.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $139.81 / $380.35 / $432.21	Professional	26	$139.81	$380.35	$432.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $310.45 / $777.33 / $972.53	Professional	TC	$310.45	$777.33	$972.53
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $1,016.96 / $1,016.96 / $2,330.00	Facility	26	$1,016.96	$1,016.96	$2,330.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $462.48 / $1,157.46 / $6,199.75	Professional		$462.48	$1,157.46	$6,199.75
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $135.65 / $327.82 / $931.20	Professional	26	$135.65	$327.82	$931.20
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $315.52 / $789.00 / $5,551.18	Professional	TC	$315.52	$789.00	$5,551.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $80.83 / $191.29 / $555.06	Professional		$80.83	$191.29	$555.06
Quartz Facility/Professional Professional Modifier Low / Median / High Price $633.10 / $948.48 / $2,581.91	Professional		$633.10	$948.48	$2,581.91
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $258.38 / $1,016.96 / $1,016.96	Facility	26	$258.38	$1,016.96	$1,016.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $499.19 / $3,380.16 / $6,199.75	Professional		$499.19	$3,380.16	$6,199.75
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $160.19 / $565.20 / $931.20	Professional	26	$160.19	$565.20	$931.20
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $330.06 / $2,979.62 / $5,551.18	Professional	TC	$330.06	$2,979.62	$5,551.18
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,058.39 / $2,062.85 / $2,837.18	Professional		$2,058.39	$2,062.85	$2,837.18
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $455.18 / $689.45 / $820.03	Professional	26	$455.18	$689.45	$820.03
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,216.96 / $1,552.85 / $2,471.40	Professional	TC	$1,216.96	$1,552.85	$2,471.40
United Facility/Professional Professional Modifier Low / Median / High Price $394.26 / $979.69 / $2,194.92	Professional		$394.26	$979.69	$2,194.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $125.92 / $282.26 / $524.71	Professional	26	$125.92	$282.26	$524.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $291.25 / $655.75 / $1,908.44	Professional	TC	$291.25	$655.75	$1,908.44