Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $55.98 / $231.47 / $549.29	Facility		$55.98	$231.47	$549.29
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.59 / $14.47 / $17.48	Facility	26	$12.59	$14.47	$17.48
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $36.09 / $275.27 / $373.18	Facility	TC	$36.09	$275.27	$373.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.34 / $48.68 / $180.43	Professional		$28.34	$48.68	$180.43
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.53 / $12.84 / $91.68	Professional	26	$7.53	$12.84	$91.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.79 / $31.36 / $96.41	Professional	TC	$20.79	$31.36	$96.41
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.06 / $64.20 / $177.13	Professional		$30.06	$64.20	$177.13
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.11 / $18.76 / $52.25	Professional	26	$8.11	$18.76	$52.25
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.03 / $47.60 / $131.49	Professional	TC	$21.03	$47.60	$131.49
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.69 / $28.02 / $39.90	Facility		$8.69	$28.02	$39.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $9.28 / $28.12 / $44.06	Professional		$9.28	$28.12	$44.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $88.31 / $103.20 / $137.16	Facility		$88.31	$103.20	$137.16
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.63 / $25.27 / $33.59	Facility	26	$21.63	$25.27	$33.59
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $66.68 / $77.92 / $103.57	Facility	TC	$66.68	$77.92	$103.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.38 / $114.27 / $129.85	Professional		$34.38	$114.27	$129.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.52 / $29.44 / $33.45	Professional	26	$9.52	$29.44	$33.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.88 / $84.83 / $96.40	Professional	TC	$24.88	$84.83	$96.40
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $28.29 / $48.68 / $67.14	Facility		$28.29	$48.68	$67.14
Medica Facility/Professional Facility Modifier Low / Median / High Price $27.94 / $48.68 / $243.69	Facility		$27.94	$48.68	$243.69
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $62.70 / $100.00 / $100.00	Facility	26	$62.70	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $110.49 / $233.12 / $461.20	Facility	TC	$110.49	$233.12	$461.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $32.79 / $78.00 / $208.83	Professional		$32.79	$78.00	$208.83
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.86 / $23.43 / $82.56	Professional	26	$9.86	$23.43	$82.56
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $22.87 / $55.51 / $176.00	Professional	TC	$22.87	$55.51	$176.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.34 / $33.89 / $74.33	Professional		$19.34	$33.89	$74.33
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $28.29 / $48.68 / $67.14	Facility		$28.29	$48.68	$67.14
Quartz Facility/Professional Professional Modifier Low / Median / High Price $63.70 / $95.43 / $133.13	Professional		$63.70	$95.43	$133.13
Quartz Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $342.77 / $342.77	Facility		$80.00	$342.77	$342.77
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Quartz Facility/Professional Facility Modifier TC Low / Median / High Price $100.00 / $110.49 / $110.49	Facility	TC	$100.00	$110.49	$110.49
Quartz Facility/Professional Professional Modifier Low / Median / High Price $50.47 / $150.00 / $208.83	Professional		$50.47	$150.00	$208.83
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $13.64 / $43.25 / $82.56	Professional	26	$13.64	$43.25	$82.56
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $35.72 / $106.75 / $176.00	Professional	TC	$35.72	$106.75	$176.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $60.05 / $182.91 / $203.59	Professional		$60.05	$182.91	$203.59
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.26 / $24.37 / $47.48	Professional	26	$19.26	$24.37	$47.48
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $40.78 / $51.59 / $117.54	Professional	TC	$40.78	$51.59	$117.54
United Facility/Professional Professional Modifier Low / Median / High Price $31.76 / $64.50 / $131.47	Professional		$31.76	$64.50	$131.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.44 / $20.30 / $37.90	Professional	26	$9.44	$20.30	$37.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.74 / $47.62 / $93.68	Professional	TC	$22.74	$47.62	$93.68