Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $257.04 / $549.54	Facility		$67.61	$257.04	$549.54
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.02 / $14.45 / $21.38	Facility	26	$12.02	$14.45	$21.38
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $41.69 / $251.19 / $371.54	Facility	TC	$41.69	$251.19	$371.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $47.86 / $125.89	Professional		$26.92	$47.86	$125.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $14.13 / $42.66	Professional	26	$7.08	$14.13	$42.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $28.84 / $74.13	Professional	TC	$19.05	$28.84	$74.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $48.98 / $165.96	Professional		$30.20	$48.98	$165.96
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $12.59 / $43.65	Professional	26	$8.13	$12.59	$43.65
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $36.31 / $117.49	Professional	TC	$20.89	$36.31	$117.49
CareSource Facility/Professional Facility Modifier Low / Median / High Price $11.75 / $34.67 / $51.29	Facility		$11.75	$34.67	$51.29
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.72 / $28.84 / $41.69	Professional		$10.72	$28.84	$41.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $102.33 / $165.96	Facility		$89.13	$102.33	$165.96
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.88 / $25.12 / $40.74	Facility	26	$21.88	$25.12	$40.74
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $66.07 / $77.62 / $123.03	Facility	TC	$66.07	$77.62	$123.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $69.18 / $131.83	Professional		$31.62	$69.18	$131.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $17.78 / $33.88	Professional	26	$8.91	$17.78	$33.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $52.48 / $97.72	Professional	TC	$22.39	$52.48	$97.72
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $54.95 / $295.12	Facility		$28.18	$54.95	$295.12
DeanCare Facility/Professional Facility Modifier TC Low / Median / High Price $223.87 / $269.15 / $354.81	Facility	TC	$223.87	$269.15	$354.81
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $70.79 / $95.50	Professional		$60.26	$70.79	$95.50
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $18.62 / $24.55	Professional	26	$15.49	$18.62	$24.55
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $52.48 / $70.79	Professional	TC	$44.67	$52.48	$70.79
Medica Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $53.70 / $257.04	Facility		$28.18	$53.70	$257.04
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $63.10 / $100.00 / $100.00	Facility	26	$63.10	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $109.65 / $234.42 / $457.09	Facility	TC	$109.65	$234.42	$457.09
Medica Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $61.66 / $208.93	Professional		$30.90	$61.66	$208.93
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $19.95 / $83.18	Professional	26	$9.12	$19.95	$83.18
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $44.67 / $177.83	Professional	TC	$22.39	$44.67	$177.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $70.79	Professional		$32.36	$33.11	$70.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $81.28 / $120.23	Professional		$41.69	$81.28	$120.23
Quartz Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $363.08 / $363.08	Facility		$79.43	$363.08	$363.08
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 / $154.88 / $154.88	Facility	TC	$100.00	$154.88	$154.88
Quartz Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $151.36 / $208.93	Professional		$36.31	$151.36	$208.93
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $43.65 / $83.18	Professional	26	$10.47	$43.65	$83.18
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $107.15 / $177.83	Professional	TC	$26.30	$107.15	$177.83
Security Health Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $147.91 / $204.17	Professional		$60.26	$147.91	$204.17
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $23.44 / $43.65	Professional	26	$19.05	$23.44	$43.65
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $50.12 / $107.15	Professional	TC	$40.74	$50.12	$107.15
United Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $229.09 / $302.00	Facility		$229.09	$229.09	$302.00
United Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $44.67 / $109.65	Professional		$30.20	$44.67	$109.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $13.18 / $29.51	Professional	26	$8.71	$13.18	$29.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $31.62 / $77.62	Professional	TC	$21.38	$31.62	$77.62