Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $161.37 / $180.15 / $207.17	Facility	26	$161.37	$180.15	$207.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $345.88 / $760.91 / $3,663.50	Professional		$345.88	$760.91	$3,663.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.79 / $180.15 / $816.00	Professional	26	$78.79	$180.15	$816.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $252.76 / $368.50 / $663.09	Professional	TC	$252.76	$368.50	$663.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $317.05 / $777.60 / $2,514.39	Professional		$317.05	$777.60	$2,514.39
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $75.06 / $178.48 / $590.72	Professional	26	$75.06	$178.48	$590.72
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $241.98 / $603.95 / $1,923.67	Professional	TC	$241.98	$603.95	$1,923.67
CareSource Facility/Professional Professional Modifier Low / Median / High Price $85.67 / $277.04 / $426.77	Professional		$85.67	$277.04	$426.77
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $201.85 / $235.88 / $313.50	Facility	26	$201.85	$235.88	$313.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $453.78 / $1,133.78 / $1,288.39	Professional		$453.78	$1,133.78	$1,288.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $86.66 / $270.86 / $307.80	Professional	26	$86.66	$270.86	$307.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $342.60 / $862.88 / $980.55	Professional	TC	$342.60	$862.88	$980.55
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $723.52 / $723.52 / $723.52	Facility	26	$723.52	$723.52	$723.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $457.50 / $1,023.47 / $3,348.15	Professional		$457.50	$1,023.47	$3,348.15
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $96.48 / $217.88 / $586.14	Professional	26	$96.48	$217.88	$586.14
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $354.28 / $853.02 / $2,941.88	Professional	TC	$354.28	$853.02	$2,941.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $80.83 / $207.99 / $615.87	Professional		$80.83	$207.99	$615.87
Quartz Facility/Professional Professional Modifier Low / Median / High Price $614.25 / $920.24 / $1,459.46	Professional		$614.25	$920.24	$1,459.46
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $184.00 / $723.52 / $723.52	Facility	26	$184.00	$723.52	$723.52
Quartz Facility/Professional Professional Modifier Low / Median / High Price $477.52 / $1,834.75 / $3,348.15	Professional		$477.52	$1,834.75	$3,348.15
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $114.08 / $402.00 / $586.14	Professional	26	$114.08	$402.00	$586.14
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $363.43 / $1,582.85 / $2,941.88	Professional	TC	$363.43	$1,582.85	$2,941.88
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,881.39 / $2,020.25 / $2,447.85	Professional		$1,881.39	$2,020.25	$2,447.85
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $364.14 / $438.55 / $582.03	Professional	26	$364.14	$438.55	$582.03
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,342.98 / $1,738.37 / $2,067.62	Professional	TC	$1,342.98	$1,738.37	$2,067.62
United Facility/Professional Professional Modifier Low / Median / High Price $402.33 / $932.27 / $1,722.32	Professional		$402.33	$932.27	$1,722.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $91.48 / $200.76 / $352.35	Professional	26	$91.48	$200.76	$352.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $310.67 / $734.71 / $1,362.44	Professional	TC	$310.67	$734.71	$1,362.44