Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $251.19 / $457.09	Facility		$91.20	$251.19	$457.09
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.02 / $13.80 / $20.42	Facility	26	$12.02	$13.80	$20.42
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $36.31 / $218.78 / $660.69	Facility	TC	$36.31	$218.78	$660.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.72 / $32.36 / $97.72	Professional		$10.72	$32.36	$97.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $13.80 / $48.98	Professional	26	$7.08	$13.80	$48.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $28.18 / $72.44	Professional	TC	$18.62	$28.18	$72.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $47.86 / $162.18	Professional		$30.20	$47.86	$162.18
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $12.02 / $40.74	Professional	26	$7.76	$12.02	$40.74
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $34.67 / $114.82	Professional	TC	$20.89	$34.67	$114.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10.72 / $34.67 / $50.12	Facility		$10.72	$34.67	$50.12
CareSource Facility/Professional Professional Modifier Low / Median / High Price $9.77 / $28.84 / $40.74	Professional		$9.77	$28.84	$40.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $100.00 / $162.18	Facility		$87.10	$100.00	$162.18
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.95 / $22.91 / $37.15	Facility	26	$19.95	$22.91	$37.15
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 / $74.13 / $128.82	Professional		$31.62	$74.13	$128.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $16.98 / $31.62	Professional	26	$8.51	$16.98	$31.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $53.70 / $97.72	Professional	TC	$22.39	$53.70	$97.72
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $50.12 / $295.12	Facility		$27.54	$50.12	$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 $58.88 / $70.79 / $95.50	Professional		$58.88	$70.79	$95.50
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $16.98 / $22.91	Professional	26	$14.13	$16.98	$22.91
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $51.29 / $67.61	Professional	TC	$44.67	$51.29	$67.61
Medica Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $50.12 / $331.13	Facility		$28.18	$50.12	$331.13
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $134.90	Facility	26	$100.00	$100.00	$134.90
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $107.15 / $251.19 / $426.58	Facility	TC	$107.15	$251.19	$426.58
Medica Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $61.66 / $204.17	Professional		$30.20	$61.66	$204.17
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $19.05 / $74.13	Professional	26	$8.91	$19.05	$74.13
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $44.67 / $177.83	Professional	TC	$21.88	$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 / $128.82	Professional		$41.69	$81.28	$128.82
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 / $204.17	Professional		$36.31	$151.36	$204.17
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $41.69 / $74.13	Professional	26	$10.00	$41.69	$74.13
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $109.65 / $177.83	Professional	TC	$26.30	$109.65	$177.83
Security Health Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $144.54 / $199.53	Professional		$61.66	$144.54	$199.53
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $22.91 / $38.02	Professional	26	$18.62	$22.91	$38.02
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $53.70 / $107.15	Professional	TC	$43.65	$53.70	$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 / $12.59 / $28.18	Professional	26	$8.71	$12.59	$28.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $32.36 / $79.43	Professional	TC	$20.89	$32.36	$79.43