Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $144.86 / $161.72 / $226.42	Facility	26	$144.86	$161.72	$226.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.63 / $554.74 / $1,706.28	Professional		$251.63	$554.74	$1,706.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.48 / $161.72 / $718.25	Professional	26	$72.48	$161.72	$718.25
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $122.06 / $190.69 / $322.56	Professional	52	$122.06	$190.69	$322.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $179.15 / $348.53 / $812.00	Professional	TC	$179.15	$348.53	$812.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $231.14 / $589.41 / $1,831.86	Professional		$231.14	$589.41	$1,831.86
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $67.39 / $160.22 / $529.59	Professional	26	$67.39	$160.22	$529.59
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $163.75 / $417.57 / $1,359.73	Professional	TC	$163.75	$417.57	$1,359.73
CareSource Facility/Professional Professional Modifier Low / Median / High Price $76.95 / $194.24 / $314.08	Professional		$76.95	$194.24	$314.08
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $181.13 / $211.66 / $281.31	Facility	26	$181.13	$211.66	$281.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $333.31 / $828.88 / $941.91	Professional		$333.31	$828.88	$941.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.59 / $243.08 / $276.23	Professional	26	$78.59	$243.08	$276.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $233.52 / $585.80 / $665.69	Professional	TC	$233.52	$585.80	$665.69
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $650.32 / $650.32 / $650.32	Facility	26	$650.32	$650.32	$650.32
Medica Facility/Professional Professional Modifier Low / Median / High Price $334.04 / $832.46 / $3,507.01	Professional		$334.04	$832.46	$3,507.01
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $86.53 / $195.42 / $571.29	Professional	26	$86.53	$195.42	$571.29
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $240.29 / $630.29 / $2,477.29	Professional	TC	$240.29	$630.29	$2,477.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.30 / $143.55 / $371.66	Professional		$54.30	$143.55	$371.66
Quartz Facility/Professional Professional Modifier Low / Median / High Price $451.10 / $675.82 / $1,111.27	Professional		$451.10	$675.82	$1,111.27
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $165.13 / $650.32 / $650.32	Facility	26	$165.13	$650.32	$650.32
Quartz Facility/Professional Professional Modifier Low / Median / High Price $354.64 / $1,552.22 / $3,507.01	Professional		$354.64	$1,552.22	$3,507.01
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $102.37 / $360.55 / $571.29	Professional	26	$102.37	$360.55	$571.29
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $261.52 / $1,325.29 / $2,477.29	Professional	TC	$261.52	$1,325.29	$2,477.29
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,476.94 / $1,476.94 / $2,388.36	Professional		$1,476.94	$1,476.94	$2,388.36
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $303.45 / $395.97 / $524.48	Professional	26	$303.45	$395.97	$524.48
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $915.41 / $1,769.64 / $2,104.81	Professional	TC	$915.41	$1,769.64	$2,104.81
United Facility/Professional Professional Modifier Low / Median / High Price $308.33 / $679.83 / $1,317.24	Professional		$308.33	$679.83	$1,317.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $87.90 / $273.61 / $554.85	Professional	26	$87.90	$273.61	$554.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $210.71 / $488.27 / $1,066.40	Professional	TC	$210.71	$488.27	$1,066.40