Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $302.00 / $478.63	Facility		$128.82	$302.00	$478.63
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.02 / $17.38 / $407.38	Facility	26	$12.02	$17.38	$407.38
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $33.11 / $346.74 / $446.68	Facility	TC	$33.11	$346.74	$446.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $43.65 / $107.15	Professional		$21.88	$43.65	$107.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $11.75 / $45.71	Professional	26	$7.76	$11.75	$45.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $23.99 / $60.26	Professional	TC	$15.14	$23.99	$60.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $44.67 / $144.54	Professional		$26.92	$44.67	$144.54
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $12.59 / $43.65	Professional	26	$8.13	$12.59	$43.65
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $32.36 / $100.00	Professional	TC	$18.62	$32.36	$100.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $11.75 / $28.18 / $44.67	Facility		$11.75	$28.18	$44.67
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.72 / $23.44 / $35.48	Professional		$10.72	$23.44	$35.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $87.10 / $138.04	Facility		$74.13	$87.10	$138.04
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.88 / $25.12 / $40.74	Facility	26	$21.88	$25.12	$40.74
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $53.70 / $61.66 / $100.00	Facility	TC	$53.70	$61.66	$100.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $61.66 / $112.20	Professional		$28.18	$61.66	$112.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $17.78 / $33.88	Professional	26	$8.91	$17.78	$33.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $45.71 / $79.43	Professional	TC	$19.50	$45.71	$79.43
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $24.55 / $48.98 / $295.12	Facility		$24.55	$48.98	$295.12
DeanCare Facility/Professional Facility Modifier TC Low / Median / High Price $223.87 / $269.15 / $354.81	Facility	TC	$223.87	$269.15	$354.81
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $61.66 / $83.18	Professional		$51.29	$61.66	$83.18
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $18.62 / $25.12	Professional	26	$15.49	$18.62	$25.12
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $42.66 / $58.88	Professional	TC	$36.31	$42.66	$58.88
Medica Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $51.29 / $295.12	Facility		$25.12	$51.29	$295.12
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 / $316.23 / $416.87	Facility	TC	$100.00	$316.23	$416.87
Medica Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $60.26 / $177.83	Professional		$27.54	$60.26	$177.83
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $22.39 / $89.13	Professional	26	$9.12	$22.39	$89.13
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $39.81 / $162.18	Professional	TC	$19.05	$39.81	$162.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $70.79	Professional		$32.36	$33.11	$70.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $70.79 / $131.83	Professional		$36.31	$70.79	$131.83
Quartz Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $363.08 / $363.08	Facility		$77.62	$363.08	$363.08
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 / $125.89 / $125.89	Facility	TC	$100.00	$125.89	$125.89
Quartz Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $141.25 / $177.83	Professional		$38.02	$141.25	$177.83
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $43.65 / $77.62	Professional	26	$10.47	$43.65	$77.62
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $97.72 / $162.18	Professional	TC	$27.54	$97.72	$162.18
Security Health Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $125.89 / $173.78	Professional		$69.18	$125.89	$173.78
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $23.44 / $39.81	Professional	26	$19.05	$23.44	$39.81
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $58.88 / $87.10	Professional	TC	$48.98	$58.88	$87.10
United Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $275.42 / $363.08	Facility		$275.42	$275.42	$363.08
United Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $43.65 / $97.72	Professional		$27.54	$43.65	$97.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $13.18 / $29.51	Professional	26	$8.71	$13.18	$29.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $29.51 / $69.18	Professional	TC	$19.05	$29.51	$69.18