Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $188.10 / $354.12 / $622.50	Facility		$188.10	$354.12	$622.50
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.09 / $16.79 / $562.59	Facility	26	$12.09	$16.79	$562.59
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $53.87 / $345.32 / $763.79	Facility	TC	$53.87	$345.32	$763.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.20 / $65.84 / $240.35	Professional		$19.20	$65.84	$240.35
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.69 / $21.43 / $89.50	Professional	26	$7.69	$21.43	$89.50
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $16.22 / $99.60 / $540.00	Professional	50	$16.22	$99.60	$540.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $14.87 / $18.02 / $34.52	Professional	52	$14.87	$18.02	$34.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.86 / $49.80 / $177.60	Professional	TC	$23.86	$49.80	$177.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.03 / $67.50 / $186.21	Professional		$31.03	$67.50	$186.21
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.80 / $18.02 / $50.19	Professional	26	$7.80	$18.02	$50.19
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $46.16 / $110.58 / $308.76	Professional	50	$46.16	$110.58	$308.76
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.46 / $50.09 / $142.38	Professional	TC	$22.46	$50.09	$142.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.36 / $29.93 / $41.90	Facility		$8.36	$29.93	$41.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.94 / $30.06 / $45.86	Professional		$8.94	$30.06	$45.86
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 $33.89 / $120.12 / $136.50	Professional		$33.89	$120.12	$136.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.50 / $28.26 / $32.11	Professional	26	$9.50	$28.26	$32.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $91.86 / $104.39	Professional	TC	$24.55	$91.86	$104.39
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $29.21 / $45.60 / $71.29	Facility		$29.21	$45.60	$71.29
Medica Facility/Professional Facility Modifier Low / Median / High Price $29.89 / $159.65 / $342.77	Facility		$29.89	$159.65	$342.77
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $62.00 / $100.00 / $163.69	Facility	26	$62.00	$100.00	$163.69
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $118.08 / $277.50 / $423.41	Facility	TC	$118.08	$277.50	$423.41
Medica Facility/Professional Professional Modifier Low / Median / High Price $34.89 / $85.01 / $223.55	Professional		$34.89	$85.01	$223.55
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.97 / $28.34 / $78.30	Professional	26	$9.97	$28.34	$78.30
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $24.70 / $59.95 / $170.86	Professional	TC	$24.70	$59.95	$170.86
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 $29.21 / $48.23 / $71.29	Facility		$29.21	$48.23	$71.29
Quartz Facility/Professional Professional Modifier Low / Median / High Price $66.30 / $99.33 / $128.19	Professional		$66.30	$99.33	$128.19
Quartz Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $342.77 / $342.77	Facility		$91.20	$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 $55.83 / $156.85 / $221.82	Professional		$55.83	$156.85	$221.82
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $13.10 / $41.55 / $71.00	Professional	26	$13.10	$41.55	$71.00
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $39.32 / $115.30 / $170.86	Professional	TC	$39.32	$115.30	$170.86
Security Health Facility/Professional Professional Modifier Low / Median / High Price $62.34 / $194.61 / $214.06	Professional		$62.34	$194.61	$214.06
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.50 / $23.41 / $45.62	Professional	26	$18.50	$23.41	$45.62
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $43.83 / $51.41 / $134.44	Professional	TC	$43.83	$51.41	$134.44
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 $33.20 / $68.90 / $137.47	Professional		$33.20	$68.90	$137.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.90 / $17.87 / $36.42	Professional	26	$8.90	$17.87	$36.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.54 / $52.24 / $101.06	Professional	TC	$24.54	$52.24	$101.06