Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $213.80 / $275.42 / $275.42	Facility	26	$213.80	$275.42	$275.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $524.81 / $1,445.44	Professional		$234.42	$524.81	$1,445.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $194.98 / $524.81	Professional	26	$102.33	$194.98	$524.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $407.38 / $912.01	Professional	TC	$295.12	$407.38	$912.01
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $630.96 / $2,290.87	Professional		$389.05	$630.96	$2,290.87
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $154.88 / $575.44	Professional	26	$100.00	$154.88	$575.44
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $501.19 / $1,737.80	Professional	TC	$295.12	$501.19	$1,737.80
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $269.15 / $316.23 / $501.19	Facility	26	$269.15	$316.23	$501.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $1,071.52 / $1,621.81	Professional		$426.58	$1,071.52	$1,621.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $218.78 / $416.87	Professional	26	$93.33	$218.78	$416.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $331.13 / $851.14 / $1,202.26	Professional	TC	$331.13	$851.14	$1,202.26
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $870.96 / $1,202.26	Professional		$724.44	$870.96	$1,202.26
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $186.21 / $223.87 / $302.00	Professional	26	$186.21	$223.87	$302.00
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $537.03 / $630.96 / $912.01	Professional	TC	$537.03	$630.96	$912.01
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $954.99 / $954.99 / $2,691.53	Facility	26	$954.99	$954.99	$2,691.53
Medica Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $1,122.02 / $6,025.60	Professional		$524.81	$1,122.02	$6,025.60
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $239.88 / $891.25	Professional	26	$109.65	$239.88	$891.25
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $398.11 / $870.96 / $5,495.41	Professional	TC	$398.11	$870.96	$5,495.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $707.95	Professional		$32.36	$33.11	$707.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $977.24 / $2,454.71	Professional		$501.19	$977.24	$2,454.71
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $239.88 / $933.25 / $933.25	Facility	26	$239.88	$933.25	$933.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $3,388.44 / $6,165.95	Professional		$562.34	$3,388.44	$6,165.95
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $125.89 / $524.81 / $891.25	Professional	26	$125.89	$524.81	$891.25
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $436.52 / $3,090.30 / $5,623.41	Professional	TC	$436.52	$3,090.30	$5,623.41
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,137.96 / $2,511.89 / $3,467.37	Professional		$2,137.96	$2,511.89	$3,467.37
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $457.09 / $616.60 / $794.33	Professional	26	$457.09	$616.60	$794.33
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,548.82 / $2,137.96 / $2,630.27	Professional	TC	$1,548.82	$2,137.96	$2,630.27
United Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $851.14 / $1,949.84	Professional		$467.74	$851.14	$1,949.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $177.83 / $389.05	Professional	26	$109.65	$177.83	$389.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $354.81 / $645.65 / $1,621.81	Professional	TC	$354.81	$645.65	$1,621.81