Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $106.94 / $114.89 / $114.89	Facility	26	$106.94	$114.89	$114.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $167.29 / $331.29 / $521.58	Professional		$167.29	$331.29	$521.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.75 / $106.31 / $467.50	Professional	26	$54.75	$106.31	$467.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $119.70 / $227.06 / $422.51	Professional	TC	$119.70	$227.06	$422.51
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $167.00 / $415.42 / $1,310.82	Professional		$167.00	$415.42	$1,310.82
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.47 / $127.13 / $419.42	Professional	26	$53.47	$127.13	$419.42
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $113.53 / $289.51 / $891.40	Professional	TC	$113.53	$289.51	$891.40
CareSource Facility/Professional Professional Modifier Low / Median / High Price $61.00 / $136.96 / $229.71	Professional		$61.00	$136.96	$229.71
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $144.18 / $168.48 / $223.93	Facility	26	$144.18	$168.48	$223.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $243.57 / $601.41 / $683.43	Professional		$243.57	$601.41	$683.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.84 / $192.62 / $218.89	Professional	26	$62.84	$192.62	$218.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $164.43 / $408.79 / $464.54	Professional	TC	$164.43	$408.79	$464.54
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $514.88 / $514.88 / $514.88	Facility	26	$514.88	$514.88	$514.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $224.92 / $517.12 / $1,638.03	Professional		$224.92	$517.12	$1,638.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $65.42 / $151.02 / $376.34	Professional	26	$65.42	$151.02	$376.34
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $156.31 / $407.67 / $1,335.34	Professional	TC	$156.31	$407.67	$1,335.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $56.22 / $130.87 / $312.33	Professional		$56.22	$130.87	$312.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $329.55 / $493.72 / $927.52	Professional		$329.55	$493.72	$927.52
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $130.85 / $514.88 / $514.88	Facility	26	$130.85	$514.88	$514.88
Quartz Facility/Professional Professional Modifier Low / Median / High Price $253.29 / $937.15 / $1,638.03	Professional		$253.29	$937.15	$1,638.03
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $81.12 / $285.85 / $376.34	Professional	26	$81.12	$285.85	$376.34
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $175.15 / $744.85 / $1,335.34	Professional	TC	$175.15	$744.85	$1,335.34
Security Health Facility/Professional Professional Modifier Low / Median / High Price $731.16 / $1,071.61 / $1,071.61	Professional		$731.16	$1,071.61	$1,071.61
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $191.82 / $197.24 / $313.39	Professional	26	$191.82	$197.24	$313.39
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $411.00 / $539.34 / $1,147.00	Professional	TC	$411.00	$539.34	$1,147.00
United Facility/Professional Professional Modifier Low / Median / High Price $204.91 / $487.56 / $821.41	Professional		$204.91	$487.56	$821.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $62.37 / $116.86 / $250.55	Professional	26	$62.37	$116.86	$250.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $139.80 / $344.09 / $608.85	Professional	TC	$139.80	$344.09	$608.85