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 $349.93 / $598.50 / $3,500.10	Professional		$349.93	$598.50	$3,500.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $110.82 / $271.64 / $1,241.00	Professional	26	$110.82	$271.64	$1,241.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $237.52 / $406.56 / $1,214.40	Professional	TC	$237.52	$406.56	$1,214.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $322.04 / $778.15 / $2,538.92	Professional		$322.04	$778.15	$2,538.92
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 $216.44 / $534.42 / $1,712.35	Professional	TC	$216.44	$534.42	$1,712.35
CareSource Facility/Professional Professional Modifier Low / Median / High Price $121.04 / $257.54 / $440.10	Professional		$121.04	$257.54	$440.10
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 $466.29 / $1,155.34 / $1,312.90	Professional		$466.29	$1,155.34	$1,312.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $129.05 / $380.35 / $432.21	Professional	26	$129.05	$380.35	$432.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $309.50 / $774.97 / $972.53	Professional	TC	$309.50	$774.97	$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 $461.59 / $1,153.98 / $6,146.58	Professional		$461.59	$1,153.98	$6,146.58
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $135.65 / $313.12 / $921.60	Professional	26	$135.65	$313.12	$921.60
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $314.64 / $788.00 / $5,551.18	Professional	TC	$314.64	$788.00	$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 $631.79 / $946.53 / $2,608.80	Professional		$631.79	$946.53	$2,608.80
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 $498.17 / $3,347.26 / $6,146.58	Professional		$498.17	$3,347.26	$6,146.58
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $160.19 / $565.20 / $921.60	Professional	26	$160.19	$565.20	$921.60
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $329.04 / $2,979.62 / $5,551.18	Professional	TC	$329.04	$2,979.62	$5,551.18
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,054.52 / $4,532.34 / $4,532.34	Professional		$2,054.52	$4,532.34	$4,532.34
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $481.95 / $1,417.16 / $1,417.16	Professional	26	$481.95	$1,417.16	$1,417.16
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,423.68 / $3,115.18 / $3,115.18	Professional	TC	$1,423.68	$3,115.18	$3,115.18
United Facility/Professional Professional Modifier Low / Median / High Price $86.60 / $715.52 / $2,474.56	Professional		$86.60	$715.52	$2,474.56
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 $275.91 / $653.48 / $1,817.56	Professional	TC	$275.91	$653.48	$1,817.56