Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.26 / $107.71 / $107.71	Facility	26	$100.26	$107.71	$107.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $133.91 / $266.58 / $730.00	Professional		$133.91	$266.58	$730.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.60 / $100.26 / $476.85	Professional	26	$49.60	$100.26	$476.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $90.97 / $166.33 / $297.92	Professional	TC	$90.97	$166.33	$297.92
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $133.29 / $311.80 / $1,043.05	Professional		$133.29	$311.80	$1,043.05
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $50.13 / $119.19 / $393.18	Professional	26	$50.13	$119.19	$393.18
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $83.16 / $196.22 / $649.88	Professional	TC	$83.16	$196.22	$649.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $57.20 / $100.31 / $184.04	Professional		$57.20	$100.31	$184.04
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $135.16 / $157.94 / $209.93	Facility	26	$135.16	$157.94	$209.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $191.30 / $479.85 / $545.29	Professional		$191.30	$479.85	$545.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.39 / $180.51 / $205.13	Professional	26	$59.39	$180.51	$205.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $120.60 / $299.33 / $340.16	Professional	TC	$120.60	$299.33	$340.16
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $482.96 / $482.96 / $482.96	Facility	26	$482.96	$482.96	$482.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $168.88 / $424.86 / $1,593.12	Professional		$168.88	$424.86	$1,593.12
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $61.19 / $141.63 / $325.83	Professional	26	$61.19	$141.63	$325.83
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $104.53 / $283.10 / $1,318.35	Professional	TC	$104.53	$283.10	$1,318.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $56.22 / $105.44 / $253.57	Professional		$56.22	$105.44	$253.57
Quartz Facility/Professional Professional Modifier Low / Median / High Price $263.25 / $394.39 / $856.07	Professional		$263.25	$394.39	$856.07
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $122.63 / $482.96 / $482.96	Facility	26	$122.63	$482.96	$482.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $202.11 / $878.23 / $1,593.12	Professional		$202.11	$878.23	$1,593.12
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $76.03 / $268.10 / $325.83	Professional	26	$76.03	$268.10	$325.83
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $128.08 / $708.03 / $1,318.35	Professional	TC	$128.08	$708.03	$1,318.35
Security Health Facility/Professional Professional Modifier Low / Median / High Price $474.01 / $855.03 / $855.03	Professional		$474.01	$855.03	$855.03
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $180.61 / $182.07 / $291.91	Professional	26	$180.61	$182.07	$291.91
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $293.39 / $371.24 / $684.88	Professional	TC	$293.39	$371.24	$684.88
United Facility/Professional Professional Modifier Low / Median / High Price $163.38 / $368.04 / $730.79	Professional		$163.38	$368.04	$730.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $59.04 / $130.38 / $234.99	Professional	26	$59.04	$130.38	$234.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $99.95 / $235.20 / $516.98	Professional	TC	$99.95	$235.20	$516.98