Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $162.18 / $208.93 / $309.03	Facility	26	$162.18	$208.93	$309.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $478.63 / $1,258.93	Professional		$165.96	$478.63	$1,258.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $162.18 / $501.19	Professional	26	$77.62	$162.18	$501.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $338.84 / $630.96	Professional	TC	$245.47	$338.84	$630.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $501.19 / $1,862.09	Professional		$316.23	$501.19	$1,862.09
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $117.49 / $436.52	Professional	26	$75.86	$117.49	$436.52
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $398.11 / $1,412.54	Professional	TC	$239.88	$398.11	$1,412.54
CareSource Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $281.84 / $398.11	Professional		$97.72	$281.84	$398.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $204.17 / $234.42 / $380.19	Facility	26	$204.17	$234.42	$380.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $758.58 / $1,318.26	Professional		$338.84	$758.58	$1,318.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $177.83 / $316.23	Professional	26	$70.79	$177.83	$316.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $616.60 / $1,000.00	Professional	TC	$269.15	$616.60	$1,000.00
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $691.83 / $954.99	Professional		$575.44	$691.83	$954.99
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $141.25 / $169.82 / $229.09	Professional	26	$141.25	$169.82	$229.09
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $436.52 / $524.81 / $758.58	Professional	TC	$436.52	$524.81	$758.58
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $724.44 / $724.44 / $724.44	Facility	26	$724.44	$724.44	$724.44
Medica Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $891.25 / $3,311.31	Professional		$426.58	$891.25	$3,311.31
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $181.97 / $588.84	Professional	26	$83.18	$181.97	$588.84
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $676.08 / $2,951.21	Professional	TC	$323.59	$676.08	$2,951.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $549.54	Professional		$32.36	$33.11	$549.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $794.33 / $1,412.54	Professional		$407.38	$794.33	$1,412.54
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $177.83 / $707.95 / $707.95	Facility	26	$177.83	$707.95	$707.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $1,905.46 / $3,467.37	Professional		$457.09	$1,905.46	$3,467.37
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $398.11 / $588.84	Professional	26	$95.50	$398.11	$588.84
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $354.81 / $1,659.59 / $3,019.95	Professional	TC	$354.81	$1,659.59	$3,019.95
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $2,041.74 / $2,818.38	Professional		$1,819.70	$2,041.74	$2,818.38
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $363.08 / $467.74 / $602.56	Professional	26	$363.08	$467.74	$602.56
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,288.25 / $1,737.80 / $2,137.96	Professional	TC	$1,288.25	$1,737.80	$2,137.96
United Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $645.65 / $1,348.96	Professional		$371.54	$645.65	$1,348.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $134.90 / $295.12	Professional	26	$83.18	$134.90	$295.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $524.81 / $1,122.02	Professional	TC	$295.12	$524.81	$1,122.02