Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $134.53 / $150.21 / $172.74	Facility	26	$134.53	$150.21	$172.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $300.83 / $598.50 / $1,731.23	Professional		$300.83	$598.50	$1,731.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.18 / $150.21 / $739.50	Professional	26	$67.18	$150.21	$739.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $242.77 / $419.27 / $743.45	Professional	TC	$242.77	$419.27	$743.45
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $307.36 / $752.51 / $2,433.17	Professional		$307.36	$752.51	$2,433.17
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $62.59 / $148.82 / $491.87	Professional	26	$62.59	$148.82	$491.87
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $244.77 / $608.38 / $1,941.28	Professional	TC	$244.77	$608.38	$1,941.28
CareSource Facility/Professional Professional Modifier Low / Median / High Price $71.42 / $275.32 / $412.98	Professional		$71.42	$275.32	$412.98
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $168.51 / $196.92 / $261.72	Facility	26	$168.51	$196.92	$261.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $439.59 / $1,097.94 / $1,247.66	Professional		$439.59	$1,097.94	$1,247.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.17 / $225.67 / $256.44	Professional	26	$72.17	$225.67	$256.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $346.92 / $872.27 / $991.21	Professional	TC	$346.92	$872.27	$991.21
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $603.28 / $603.28 / $603.28	Facility	26	$603.28	$603.28	$603.28
Medica Facility/Professional Professional Modifier Low / Median / High Price $439.82 / $939.50 / $2,819.97	Professional		$439.82	$939.50	$2,819.97
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $80.27 / $181.27 / $469.00	Professional	26	$80.27	$181.27	$469.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $356.04 / $794.25 / $2,495.53	Professional	TC	$356.04	$794.25	$2,495.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.30 / $196.88 / $551.18	Professional		$54.30	$196.88	$551.18
Quartz Facility/Professional Professional Modifier Low / Median / High Price $595.40 / $892.00 / $1,327.61	Professional		$595.40	$892.00	$1,327.61
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $153.30 / $603.28 / $603.28	Facility	26	$153.30	$603.28	$603.28
Quartz Facility/Professional Professional Modifier Low / Median / High Price $462.43 / $1,528.39 / $2,819.97	Professional		$462.43	$1,528.39	$2,819.97
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $95.04 / $334.45 / $469.00	Professional	26	$95.04	$334.45	$469.00
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $367.38 / $1,318.47 / $2,495.53	Professional	TC	$367.38	$1,318.47	$2,495.53
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,668.98 / $1,887.46 / $2,350.46	Professional		$1,668.98	$1,887.46	$2,350.46
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $303.45 / $365.60 / $486.04	Professional	26	$303.45	$365.60	$486.04
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,285.20 / $1,742.54 / $2,072.58	Professional	TC	$1,285.20	$1,742.54	$2,072.58
United Facility/Professional Professional Modifier Low / Median / High Price $388.48 / $875.17 / $1,898.98	Professional		$388.48	$875.17	$1,898.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $76.27 / $161.21 / $293.14	Professional	26	$76.27	$161.21	$293.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $297.98 / $723.48 / $1,227.39	Professional	TC	$297.98	$723.48	$1,227.39