Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $218.03 / $242.77 / $279.18	Facility	26	$218.03	$242.77	$279.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $370.86 / $738.63 / $3,799.50	Professional		$370.86	$738.63	$3,799.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.88 / $248.36 / $975.00	Professional	26	$104.88	$248.36	$975.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $262.73 / $422.10 / $922.61	Professional	TC	$262.73	$422.10	$922.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $340.77 / $868.97 / $2,696.84	Professional		$340.77	$868.97	$2,696.84
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $101.15 / $240.52 / $794.22	Professional	26	$101.15	$240.52	$794.22
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $239.62 / $611.03 / $1,902.62	Professional	TC	$239.62	$611.03	$1,902.62
CareSource Facility/Professional Professional Modifier Low / Median / High Price $115.93 / $283.80 / $463.23	Professional		$115.93	$283.80	$463.23
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $272.14 / $318.02 / $422.67	Facility	26	$272.14	$318.02	$422.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $491.36 / $1,218.94 / $1,385.16	Professional		$491.36	$1,218.94	$1,385.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $121.68 / $364.22 / $413.89	Professional	26	$121.68	$364.22	$413.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $341.16 / $854.68 / $1,045.65	Professional	TC	$341.16	$854.68	$1,045.65
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $973.04 / $973.04 / $2,348.00	Facility	26	$973.04	$973.04	$2,348.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $491.35 / $1,288.83 / $6,025.38	Professional		$491.35	$1,288.83	$6,025.38
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $129.82 / $299.66 / $891.52	Professional	26	$129.82	$299.66	$891.52
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $350.71 / $919.95 / $5,457.89	Professional	TC	$350.71	$919.95	$5,457.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $80.83 / $207.99 / $615.87	Professional		$80.83	$207.99	$615.87
Quartz Facility/Professional Professional Modifier Low / Median / High Price $665.60 / $997.17 / $2,461.23	Professional		$665.60	$997.17	$2,461.23
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $247.43 / $973.04 / $973.04	Facility	26	$247.43	$973.04	$973.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $524.08 / $3,287.13 / $6,025.38	Professional		$524.08	$3,287.13	$6,025.38
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $153.41 / $540.90 / $891.52	Professional	26	$153.41	$540.90	$891.52
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $362.46 / $2,935.38 / $5,457.89	Professional	TC	$362.46	$2,935.38	$5,457.89
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,124.15 / $2,171.98 / $3,242.11	Professional		$2,124.15	$2,171.98	$3,242.11
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $455.18 / $607.27 / $809.78	Professional	26	$455.18	$607.27	$809.78
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,337.39 / $2,299.10 / $2,734.55	Professional	TC	$1,337.39	$2,299.10	$2,734.55
United Facility/Professional Professional Modifier Low / Median / High Price $453.55 / $1,020.49 / $3,543.48	Professional		$453.55	$1,020.49	$3,543.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $123.04 / $270.13 / $474.10	Professional	26	$123.04	$270.13	$474.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $323.73 / $702.16 / $1,906.20	Professional	TC	$323.73	$702.16	$1,906.20