Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.44 / $253.14 / $468.95	Facility		$66.44	$253.14	$468.95
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.06 / $13.86 / $16.07	Facility	26	$12.06	$13.86	$16.07
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $36.09 / $50.52 / $366.62	Facility	TC	$36.09	$50.52	$366.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.23 / $48.15 / $175.83	Professional		$24.23	$48.15	$175.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.19 / $12.06 / $79.20	Professional	26	$7.19	$12.06	$79.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.79 / $30.84 / $74.18	Professional	TC	$20.79	$30.84	$74.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.70 / $63.51 / $173.41	Professional		$29.70	$63.51	$173.41
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.78 / $17.97 / $48.00	Professional	26	$7.78	$17.97	$48.00
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 $8.01 / $28.02 / $39.36	Facility		$8.01	$28.02	$39.36
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.53 / $28.12 / $43.13	Professional		$8.53	$28.12	$43.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $86.51 / $101.09 / $134.36	Facility		$86.51	$101.09	$134.36
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.82 / $23.17 / $30.79	Facility	26	$19.82	$23.17	$30.79
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 / $111.84 / $127.09	Professional		$34.38	$111.84	$127.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.52 / $27.05 / $30.74	Professional	26	$9.52	$27.05	$30.74
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 $27.96 / $48.15 / $65.75	Facility		$27.96	$48.15	$65.75
Medica Facility/Professional Facility Modifier Low / Median / High Price $27.96 / $48.23 / $273.25	Facility		$27.96	$48.23	$273.25
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $135.00	Facility	26	$100.00	$100.00	$135.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $92.69 / $123.47 / $427.00	Facility	TC	$92.69	$123.47	$427.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $76.77 / $204.50	Professional		$32.34	$76.77	$204.50
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.44 / $21.90 / $74.30	Professional	26	$9.44	$21.90	$74.30
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.10 / $56.39 / $176.00	Professional	TC	$23.10	$56.39	$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 $27.96 / $48.15 / $65.75	Facility		$27.96	$48.15	$65.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $62.40 / $93.48 / $135.24	Professional		$62.40	$93.48	$135.24
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 $49.46 / $149.90 / $204.50	Professional		$49.46	$149.90	$204.50
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $12.53 / $41.45 / $74.30	Professional	26	$12.53	$41.45	$74.30
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $35.72 / $108.45 / $176.00	Professional	TC	$35.72	$108.45	$176.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $62.30 / $182.79 / $199.33	Professional		$62.30	$182.79	$199.33
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.47 / $23.37 / $47.48	Professional	26	$18.47	$23.37	$47.48
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $43.83 / $54.62 / $117.54	Professional	TC	$43.83	$54.62	$117.54
United Facility/Professional Professional Modifier Low / Median / High Price $31.76 / $70.40 / $131.55	Professional		$31.76	$70.40	$131.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.96 / $18.38 / $36.33	Professional	26	$8.96	$18.38	$36.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.10 / $51.97 / $95.06	Professional	TC	$23.10	$51.97	$95.06