Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $229.09 / $288.40 / $426.58	Facility	26	$229.09	$288.40	$426.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $602.56 / $3,548.13	Professional		$331.13	$602.56	$3,548.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $218.78 / $691.83	Professional	26	$104.71	$218.78	$691.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $338.84 / $812.83	Professional	TC	$223.87	$338.84	$812.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $602.56 / $1,905.46	Professional		$323.59	$602.56	$1,905.46
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $162.18 / $616.60	Professional	26	$104.71	$162.18	$616.60
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $436.52 / $1,288.25	Professional	TC	$218.78	$436.52	$1,288.25
CareSource Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $263.03 / $416.87	Professional		$138.04	$263.03	$416.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $281.84 / $331.13 / $524.81	Facility	26	$281.84	$331.13	$524.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $1,000.00 / $1,348.96	Professional		$363.08	$1,000.00	$1,348.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $234.42 / $436.52	Professional	26	$102.33	$234.42	$436.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $660.69 / $977.24	Professional	TC	$251.19	$660.69	$977.24
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $724.44 / $977.24	Professional		$602.56	$724.44	$977.24
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $199.53 / $239.88 / $323.59	Professional	26	$199.53	$239.88	$323.59
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $398.11 / $478.63 / $676.08	Professional	TC	$398.11	$478.63	$676.08
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $1,023.29 / $1,023.29 / $2,344.23	Facility	26	$1,023.29	$1,023.29	$2,344.23
Medica Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $1,122.02 / $6,165.95	Professional		$426.58	$1,122.02	$6,165.95
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $125.89 / $275.42 / $933.25	Professional	26	$125.89	$275.42	$933.25
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $691.83 / $5,495.41	Professional	TC	$295.12	$691.83	$5,495.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $645.65	Professional		$32.36	$33.11	$645.65
Quartz Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $812.83 / $2,570.40	Professional		$416.87	$812.83	$2,570.40
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $251.19 / $1,000.00 / $1,000.00	Facility	26	$251.19	$1,000.00	$1,000.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $3,548.13 / $6,309.57	Professional		$501.19	$3,548.13	$6,309.57
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $147.91 / $562.34 / $933.25	Professional	26	$147.91	$562.34	$933.25
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $331.13 / $3,162.28 / $5,754.40	Professional	TC	$331.13	$3,162.28	$5,754.40
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $2,137.96 / $2,951.21	Professional		$1,995.26	$2,137.96	$2,951.21
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $457.09 / $691.83 / $851.14	Professional	26	$457.09	$691.83	$851.14
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,122.02 / $1,584.89 / $1,949.84	Professional	TC	$1,122.02	$1,584.89	$1,949.84
United Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $707.95 / $1,862.09	Professional		$380.19	$707.95	$1,862.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $190.55 / $416.87	Professional	26	$117.49	$190.55	$416.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $489.78 / $1,380.38	Professional	TC	$263.03	$489.78	$1,380.38