Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $107.15 / $114.82 / $181.97	Facility	26	$107.15	$114.82	$181.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $302.00 / $616.60	Professional		$218.78	$302.00	$616.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $97.72 / $208.93	Professional	26	$52.48	$97.72	$208.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $218.78 / $416.87	Professional	TC	$162.18	$218.78	$416.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $363.08 / $1,258.93	Professional		$229.09	$363.08	$1,258.93
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $83.18 / $309.03	Professional	26	$53.70	$83.18	$309.03
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $275.42 / $977.24	Professional	TC	$173.78	$275.42	$977.24
CareSource Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $208.93 / $295.12	Professional		$69.18	$208.93	$295.12
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $144.54 / $169.82 / $269.15	Facility	26	$144.54	$169.82	$269.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $549.54 / $954.99	Professional		$229.09	$549.54	$954.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $114.82 / $223.87	Professional	26	$50.12	$114.82	$223.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $371.54 / $741.31	Professional	TC	$173.78	$371.54	$741.31
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $512.86 / $691.83	Professional		$426.58	$512.86	$691.83
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $120.23 / $162.18	Professional	26	$100.00	$120.23	$162.18
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $389.05 / $524.81	Professional	TC	$323.59	$389.05	$524.81
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $512.86 / $512.86 / $512.86	Facility	26	$512.86	$512.86	$512.86
Medica Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $537.03 / $1,819.70	Professional		$269.15	$537.03	$1,819.70
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $123.03 / $363.08	Professional	26	$58.88	$123.03	$363.08
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $416.87 / $1,513.56	Professional	TC	$204.17	$416.87	$1,513.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $295.12	Professional		$32.36	$33.11	$295.12
Quartz Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $575.44 / $1,122.02	Professional		$295.12	$575.44	$1,122.02
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $128.82 / $501.19 / $501.19	Facility	26	$128.82	$501.19	$501.19
Quartz Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $1,148.15 / $1,862.09	Professional		$331.13	$1,148.15	$1,862.09
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $288.40 / $363.08	Professional	26	$69.18	$288.40	$363.08
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $870.96 / $1,584.89	Professional	TC	$239.88	$870.96	$1,584.89
Security Health Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $1,148.15 / $1,584.89	Professional		$724.44	$1,148.15	$1,584.89
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $186.21 / $194.98 / $263.03	Professional	26	$186.21	$194.98	$263.03
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $537.03 / $630.96 / $870.96	Professional	TC	$537.03	$630.96	$870.96
United Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $398.11 / $851.14	Professional		$245.47	$398.11	$851.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $91.20 / $208.93	Professional	26	$58.88	$91.20	$208.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $302.00 / $676.08	Professional	TC	$186.21	$302.00	$676.08