Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.12 / $335.40 / $491.80	Facility		$58.12	$335.40	$491.80
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.59 / $17.48 / $410.62	Facility	26	$12.59	$17.48	$410.62
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $29.11 / $317.76 / $484.72	Facility	TC	$29.11	$317.76	$484.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.98 / $41.69 / $157.34	Professional		$24.98	$41.69	$157.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $12.75 / $72.90	Professional	26	$7.94	$12.75	$72.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.76 / $26.85 / $103.55	Professional	TC	$16.76	$26.85	$103.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.90 / $59.66 / $170.33	Professional		$26.90	$59.66	$170.33
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.11 / $18.76 / $52.25	Professional	26	$8.11	$18.76	$52.25
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.78 / $40.90 / $118.08	Professional	TC	$18.78	$40.90	$118.08
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.69 / $22.66 / $34.34	Facility		$8.69	$22.66	$34.34
CareSource Facility/Professional Professional Modifier Low / Median / High Price $9.28 / $23.53 / $37.79	Professional		$9.28	$23.53	$37.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $74.79 / $87.40 / $116.16	Facility		$74.79	$87.40	$116.16
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.63 / $25.27 / $33.59	Facility	26	$21.63	$25.27	$33.59
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $53.17 / $62.13 / $82.57	Facility	TC	$53.17	$62.13	$82.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.71 / $97.86 / $111.20	Professional		$31.71	$97.86	$111.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.52 / $29.44 / $33.45	Professional	26	$9.52	$29.44	$33.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.21 / $68.41 / $77.73	Professional	TC	$22.21	$68.41	$77.73
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $24.28 / $41.69 / $63.90	Facility		$24.28	$41.69	$63.90
Medica Facility/Professional Facility Modifier Low / Median / High Price $24.28 / $49.28 / $287.32	Facility		$24.28	$49.28	$287.32
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $100.00 / $247.63 / $413.93	Facility	TC	$100.00	$247.63	$413.93
Medica Facility/Professional Professional Modifier Low / Median / High Price $29.79 / $70.88 / $178.47	Professional		$29.79	$70.88	$178.47
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.86 / $23.44 / $77.59	Professional	26	$9.86	$23.44	$77.59
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $20.02 / $48.47 / $163.00	Professional	TC	$20.02	$48.47	$163.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.34 / $33.89 / $70.00	Professional		$19.34	$33.89	$70.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $24.28 / $41.69 / $63.90	Facility		$24.28	$41.69	$63.90
Quartz Facility/Professional Professional Modifier Low / Median / High Price $54.60 / $81.80 / $132.52	Professional		$54.60	$81.80	$132.52
Quartz Facility/Professional Facility Modifier Low / Median / High Price $77.16 / $342.77 / $342.77	Facility		$77.16	$342.77	$342.77
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Quartz Facility/Professional Facility Modifier TC Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	TC	$100.00	$100.00	$100.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $45.33 / $136.30 / $178.47	Professional		$45.33	$136.30	$178.47
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $13.64 / $43.25 / $77.59	Professional	26	$13.64	$43.25	$77.59
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $30.36 / $93.05 / $163.00	Professional	TC	$30.36	$93.05	$163.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $68.44 / $163.41 / $174.33	Professional		$68.44	$163.41	$174.33
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.26 / $24.37 / $49.63	Professional	26	$19.26	$24.37	$49.63
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $49.17 / $60.69 / $113.78	Professional	TC	$49.17	$60.69	$113.78
United Facility/Professional Professional Modifier Low / Median / High Price $29.05 / $58.61 / $119.47	Professional		$29.05	$58.61	$119.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.27 / $19.80 / $37.90	Professional	26	$9.27	$19.80	$37.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.85 / $43.70 / $81.66	Professional	TC	$19.85	$43.70	$81.66