Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $106.94 / $114.89 / $114.89	Facility	26	$106.94	$114.89	$114.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $226.20 / $414.92 / $857.30	Professional		$226.20	$414.92	$857.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.75 / $106.94 / $463.14	Professional	26	$54.75	$106.94	$463.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $170.44 / $266.89 / $418.64	Professional	TC	$170.44	$266.89	$418.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $231.71 / $539.90 / $1,762.59	Professional		$231.71	$539.90	$1,762.59
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.47 / $127.13 / $419.42	Professional	26	$53.47	$127.13	$419.42
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $171.08 / $416.60 / $1,332.05	Professional	TC	$171.08	$416.60	$1,332.05
CareSource Facility/Professional Professional Modifier Low / Median / High Price $61.00 / $203.96 / $311.58	Professional		$61.00	$203.96	$311.58
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $144.18 / $168.48 / $223.93	Facility	26	$144.18	$168.48	$223.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $316.02 / $826.49 / $939.19	Professional		$316.02	$826.49	$939.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.84 / $192.62 / $218.89	Professional	26	$62.84	$192.62	$218.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $238.00 / $633.88 / $720.31	Professional	TC	$238.00	$633.88	$720.31
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $514.88 / $514.88 / $514.88	Facility	26	$514.88	$514.88	$514.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $280.81 / $634.16 / $1,817.09	Professional		$280.81	$634.16	$1,817.09
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $65.42 / $151.02 / $364.90	Professional	26	$65.42	$151.02	$364.90
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $210.29 / $487.90 / $1,526.12	Professional	TC	$210.29	$487.90	$1,526.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.40 / $182.56 / $436.16	Professional		$58.40	$182.56	$436.16
Quartz Facility/Professional Professional Modifier Low / Median / High Price $448.50 / $656.88 / $1,116.43	Professional		$448.50	$656.88	$1,116.43
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $130.85 / $514.88 / $514.88	Facility	26	$130.85	$514.88	$514.88
Quartz Facility/Professional Professional Modifier Low / Median / High Price $348.10 / $1,149.50 / $1,817.09	Professional		$348.10	$1,149.50	$1,817.09
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $81.12 / $285.85 / $364.90	Professional	26	$81.12	$285.85	$364.90
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $266.98 / $863.65 / $1,526.12	Professional	TC	$266.98	$863.65	$1,526.12
Security Health Facility/Professional Professional Modifier Low / Median / High Price $731.16 / $1,458.08 / $1,458.08	Professional		$731.16	$1,458.08	$1,458.08
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $191.82 / $197.24 / $313.39	Professional	26	$191.82	$197.24	$313.39
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $539.34 / $663.33 / $1,224.03	Professional	TC	$539.34	$663.33	$1,224.03
United Facility/Professional Professional Modifier Low / Median / High Price $267.32 / $535.88 / $1,025.55	Professional		$267.32	$535.88	$1,025.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $80.04 / $218.36 / $439.88	Professional	26	$80.04	$218.36	$439.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $201.37 / $442.10 / $880.20	Professional	TC	$201.37	$442.10	$880.20