Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.11 / $348.60 / $566.82	Facility		$87.11	$348.60	$566.82
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.41 / $15.65 / $79.54	Facility	26	$8.41	$15.65	$79.54
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $53.17 / $323.42 / $530.10	Facility	TC	$53.17	$323.42	$530.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.34 / $58.43 / $268.00	Professional		$18.34	$58.43	$268.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.61 / $21.68 / $95.90	Professional	26	$8.61	$21.68	$95.90
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $19.27 / $162.00 / $266.98	Professional	50	$19.27	$162.00	$266.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.93 / $41.91 / $216.75	Professional	TC	$21.93	$41.91	$216.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $67.70 / $189.93	Professional		$30.90	$67.70	$189.93
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.77 / $20.28 / $56.50	Professional	26	$8.77	$20.28	$56.50
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $44.61 / $110.64 / $312.30	Professional	50	$44.61	$110.64	$312.30
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.49 / $48.01 / $140.58	Professional	TC	$20.49	$48.01	$140.58
CareSource Facility/Professional Facility Modifier Low / Median / High Price $9.36 / $29.55 / $42.34	Facility		$9.36	$29.55	$42.34
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.03 / $29.67 / $46.79	Professional		$10.03	$29.67	$46.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $94.62 / $110.57 / $146.94	Facility		$94.62	$110.57	$146.94
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.43 / $27.38 / $36.39	Facility	26	$23.43	$27.38	$36.39
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $71.19 / $83.19 / $110.57	Facility	TC	$71.19	$83.19	$110.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.90 / $122.52 / $139.22	Professional		$34.90	$122.52	$139.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.15 / $31.83 / $36.18	Professional	26	$10.15	$31.83	$36.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.88 / $90.68 / $103.05	Professional	TC	$24.88	$90.68	$103.05
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $29.64 / $51.70 / $80.78	Facility		$29.64	$51.70	$80.78
Medica Facility/Professional Facility Modifier Low / Median / High Price $30.04 / $75.73 / $342.77	Facility		$30.04	$75.73	$342.77
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $67.45 / $100.00 / $162.88	Facility	26	$67.45	$100.00	$162.88
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $116.58 / $267.41 / $492.72	Facility	TC	$116.58	$267.41	$492.72
Medica Facility/Professional Professional Modifier Low / Median / High Price $34.71 / $83.82 / $221.82	Professional		$34.71	$83.82	$221.82
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $30.03 / $89.16	Professional	26	$11.22	$30.03	$89.16
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.82 / $56.98 / $177.00	Professional	TC	$23.82	$56.98	$177.00
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 $29.64 / $51.70 / $80.78	Facility		$29.64	$51.70	$80.78
Quartz Facility/Professional Professional Modifier Low / Median / High Price $67.59 / $101.28 / $148.13	Professional		$67.59	$101.28	$148.13
Quartz Facility/Professional Facility Modifier Low / Median / High Price $83.23 / $342.77 / $342.77	Facility		$83.23	$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 / $116.58 / $116.58	Facility	TC	$100.00	$116.58	$116.58
Quartz Facility/Professional Professional Modifier Low / Median / High Price $58.26 / $158.65 / $221.82	Professional		$58.26	$158.65	$221.82
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $14.75 / $46.75 / $89.16	Professional	26	$14.75	$46.75	$89.16
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $38.19 / $111.90 / $177.00	Professional	TC	$38.19	$111.90	$177.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $62.37 / $194.73 / $218.32	Professional		$62.37	$194.73	$218.32
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $20.82 / $26.34 / $53.46	Professional	26	$20.82	$26.34	$53.46
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $41.55 / $51.10 / $121.30	Professional	TC	$41.55	$51.10	$121.30
United Facility/Professional Professional Modifier Low / Median / High Price $33.56 / $67.20 / $139.06	Professional		$33.56	$67.20	$139.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.74 / $19.48 / $40.98	Professional	26	$9.74	$19.48	$40.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.63 / $48.12 / $98.08	Professional	TC	$23.63	$48.12	$98.08