Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.96 / $303.18 / $510.45	Facility		$89.96	$303.18	$510.45
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.06 / $13.86 / $16.76	Facility	26	$12.06	$13.86	$16.76
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $53.87 / $354.80 / $733.25	Facility	TC	$53.87	$354.80	$733.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $51.15 / $240.35	Professional		$19.95	$51.15	$240.35
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.69 / $18.12 / $86.00	Professional	26	$7.69	$18.12	$86.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $47.30 / $209.54 / $560.00	Professional	50	$47.30	$209.54	$560.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $14.85 / $18.02 / $35.31	Professional	52	$14.85	$18.02	$35.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.37 / $39.09 / $163.46	Professional	TC	$22.37	$39.09	$163.46
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.19 / $67.45 / $186.13	Professional		$31.19	$67.45	$186.13
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.78 / $17.97 / $50.06	Professional	26	$7.78	$17.97	$50.06
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $46.78 / $110.50 / $314.02	Professional	50	$46.78	$110.50	$314.02
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.89 / $51.55 / $142.38	Professional	TC	$22.89	$51.55	$142.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.33 / $29.93 / $41.86	Facility		$8.33	$29.93	$41.86
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.90 / $30.06 / $45.81	Professional		$8.90	$30.06	$45.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $92.82 / $108.46 / $144.16	Facility		$92.82	$108.46	$144.16
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.73 / $24.22 / $32.19	Facility	26	$20.73	$24.22	$32.19
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $72.09 / $84.24 / $111.97	Facility	TC	$72.09	$84.24	$111.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.99 / $120.04 / $136.41	Professional		$33.99	$120.04	$136.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.16 / $28.23 / $32.08	Professional	26	$10.16	$28.23	$32.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.05 / $91.86 / $104.39	Professional	TC	$24.05	$91.86	$104.39
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $29.30 / $51.15 / $70.59	Facility		$29.30	$51.15	$70.59
Medica Facility/Professional Facility Modifier Low / Median / High Price $29.40 / $60.58 / $318.75	Facility		$29.40	$60.58	$318.75
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $138.19	Facility	26	$100.00	$100.00	$138.19
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $118.08 / $250.85 / $402.24	Facility	TC	$118.08	$250.85	$402.24
Medica Facility/Professional Professional Modifier Low / Median / High Price $34.31 / $83.34 / $219.71	Professional		$34.31	$83.34	$219.71
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.44 / $25.45 / $71.40	Professional	26	$9.44	$25.45	$71.40
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $25.26 / $59.37 / $168.70	Professional	TC	$25.26	$59.37	$168.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.34 / $33.89 / $74.33	Professional		$19.34	$33.89	$74.33
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $29.30 / $51.15 / $70.59	Facility		$29.30	$51.15	$70.59
Quartz Facility/Professional Professional Modifier Low / Median / High Price $66.30 / $99.33 / $133.10	Professional		$66.30	$99.33	$133.10
Quartz Facility/Professional Facility Modifier Low / Median / High Price $84.20 / $342.77 / $342.77	Facility		$84.20	$342.77	$342.77
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 / $118.08 / $118.08	Facility	TC	$100.00	$118.08	$118.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $52.50 / $160.19 / $219.71	Professional		$52.50	$160.19	$219.71
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $13.07 / $41.45 / $67.70	Professional	26	$13.07	$41.45	$67.70
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $38.68 / $118.75 / $168.70	Professional	TC	$38.68	$118.75	$168.70
Security Health Facility/Professional Professional Modifier Low / Median / High Price $66.11 / $194.49 / $213.92	Professional		$66.11	$194.49	$213.92
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.47 / $23.37 / $51.51	Professional	26	$18.47	$23.37	$51.51
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $47.65 / $51.41 / $125.05	Professional	TC	$47.65	$51.41	$125.05
United Facility/Professional Facility Modifier Low / Median / High Price $104.04 / $104.04 / $104.04	Facility		$104.04	$104.04	$104.04
United Facility/Professional Professional Modifier Low / Median / High Price $33.92 / $75.23 / $164.43	Professional		$33.92	$75.23	$164.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.36 / $40.76 / $95.00	Professional	26	$10.36	$40.76	$95.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.26 / $50.36 / $100.91	Professional	TC	$25.26	$50.36	$100.91