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 $351.35 / $738.63 / $3,740.00	Professional		$351.35	$738.63	$3,740.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $114.44 / $288.35 / $1,249.50	Professional	26	$114.44	$288.35	$1,249.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $227.54 / $375.20 / $677.69	Professional	TC	$227.54	$375.20	$677.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $323.33 / $781.11 / $2,549.00	Professional		$323.33	$781.11	$2,549.00
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 $217.73 / $537.38 / $1,722.41	Professional	TC	$217.73	$537.38	$1,722.41
CareSource Facility/Professional Professional Modifier Low / Median / High Price $121.04 / $259.13 / $441.89	Professional		$121.04	$259.13	$441.89
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 $468.21 / $1,160.03 / $1,318.21	Professional		$468.21	$1,160.03	$1,318.21
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 $311.42 / $779.68 / $972.53	Professional	TC	$311.42	$779.68	$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 $463.37 / $1,215.46 / $6,195.24	Professional		$463.37	$1,215.46	$6,195.24
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $135.65 / $320.16 / $931.20	Professional	26	$135.65	$320.16	$931.20
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $316.42 / $791.05 / $5,551.18	Professional	TC	$316.42	$791.05	$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 $634.40 / $950.43 / $2,581.91	Professional		$634.40	$950.43	$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 $500.20 / $3,379.03 / $6,195.24	Professional		$500.20	$3,379.03	$6,195.24
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 $328.38 / $2,979.62 / $5,551.18	Professional	TC	$328.38	$2,979.62	$5,551.18
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,062.30 / $2,066.98 / $2,842.46	Professional		$2,062.30	$2,066.98	$2,842.46
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 $1,220.73 / $1,557.02 / $2,247.87	Professional	TC	$1,220.73	$1,557.02	$2,247.87
United Facility/Professional Professional Modifier Low / Median / High Price $427.73 / $962.39 / $2,516.36	Professional		$427.73	$962.39	$2,516.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $128.63 / $287.41 / $495.40	Professional	26	$128.63	$287.41	$495.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $277.47 / $655.75 / $2,149.64	Professional	TC	$277.47	$655.75	$2,149.64