Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $104.71 / $154.88	Facility	26	$51.29	$104.71	$154.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $147.91 / $512.86	Professional		$45.71	$147.91	$512.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $87.10 / $338.84	Professional	26	$44.67	$87.10	$338.84
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $43.65 / $199.53 / $660.69	Professional	50	$43.65	$199.53	$660.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $151.36 / $316.23	Professional	TC	$83.18	$151.36	$316.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $245.47 / $758.58	Professional		$128.82	$245.47	$758.58
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $70.79 / $269.15	Professional	26	$45.71	$70.79	$269.15
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $194.98 / $380.19 / $1,148.15	Professional	50	$194.98	$380.19	$1,148.15
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $173.78 / $512.86	Professional	TC	$83.18	$173.78	$512.86
CareSource Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $102.33 / $169.82	Professional		$60.26	$102.33	$169.82
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $123.03 / $144.54 / $234.42	Facility	26	$123.03	$144.54	$234.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $346.74 / $537.03	Professional		$151.36	$346.74	$537.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $97.72 / $190.55	Professional	26	$43.65	$97.72	$190.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $234.42 / $346.74	Professional	TC	$112.20	$234.42	$346.74
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $288.40 / $457.09	Professional		$245.47	$288.40	$457.09
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $104.71 / $141.25	Professional	26	$87.10	$104.71	$141.25
DeanCare Facility/Professional Professional Modifier 50 Low / Median / High Price $363.08 / $436.52 / $676.08	Professional	50	$363.08	$436.52	$676.08
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $186.21 / $323.59	Professional	TC	$154.88	$186.21	$323.59
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $446.68 / $446.68 / $1,047.13	Facility	26	$446.68	$446.68	$1,047.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $363.08 / $1,380.38	Professional		$177.83	$363.08	$1,380.38
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $123.03 / $302.00	Professional	26	$53.70	$123.03	$302.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $257.04 / $1,318.26	Professional	TC	$120.23	$257.04	$1,318.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $245.47	Professional		$32.36	$33.11	$245.47
Quartz Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $331.13 / $776.25	Professional		$169.82	$331.13	$776.25
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $109.65 / $426.58 / $426.58	Facility	26	$109.65	$426.58	$426.58
Quartz Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $794.33 / $1,412.54	Professional		$199.53	$794.33	$1,412.54
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $245.47 / $302.00	Professional	26	$61.66	$245.47	$302.00
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $616.60 / $1,318.26	Professional	TC	$134.90	$616.60	$1,318.26
Security Health Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $741.31 / $1,122.02	Professional		$588.84	$741.31	$1,122.02
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $165.96 / $181.97 / $223.87	Professional	26	$165.96	$181.97	$223.87
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $446.68 / $549.54	Professional	TC	$302.00	$446.68	$549.54
United Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $275.42 / $602.56	Professional		$158.49	$275.42	$602.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $79.43 / $177.83	Professional	26	$51.29	$79.43	$177.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $194.98 / $436.52	Professional	TC	$102.33	$194.98	$436.52