Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.40 / $133.83 / $171.85	Facility	26	$68.40	$133.83	$171.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $245.90 / $546.22 / $2,601.00	Professional		$245.90	$546.22	$2,601.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.34 / $163.06 / $748.64	Professional	26	$65.34	$163.06	$748.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $178.80 / $375.20 / $931.29	Professional	TC	$178.80	$375.20	$931.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $225.70 / $575.53 / $1,779.05	Professional		$225.70	$575.53	$1,779.05
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $62.27 / $148.05 / $486.84	Professional	26	$62.27	$148.05	$486.84
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $338.55 / $891.35 / $2,668.57	Professional	50	$338.55	$891.35	$2,668.57
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $163.43 / $416.75 / $1,337.17	Professional	TC	$163.43	$416.75	$1,337.17
CareSource Facility/Professional Professional Modifier Low / Median / High Price $71.06 / $193.85 / $306.27	Professional		$71.06	$193.85	$306.27
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $166.71 / $194.81 / $258.92	Facility	26	$166.71	$194.81	$258.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $325.23 / $807.98 / $918.16	Professional		$325.23	$807.98	$918.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.17 / $223.31 / $253.76	Professional	26	$72.17	$223.31	$253.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $233.04 / $584.63 / $664.35	Professional	TC	$233.04	$584.63	$664.35
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $596.96 / $596.96 / $596.96	Facility	26	$596.96	$596.96	$596.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $323.67 / $809.19 / $2,789.74	Professional		$323.67	$809.19	$2,789.74
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $79.84 / $180.32 / $531.65	Professional	26	$79.84	$180.32	$531.65
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $237.17 / $622.12 / $2,459.04	Professional	TC	$237.17	$622.12	$2,459.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.40 / $165.45 / $380.07	Professional		$58.40	$165.45	$380.07
Quartz Facility/Professional Professional Modifier Low / Median / High Price $440.05 / $659.26 / $1,106.47	Professional		$440.05	$659.26	$1,106.47
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $151.69 / $596.96 / $596.96	Facility	26	$151.69	$596.96	$596.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $345.62 / $1,528.39 / $2,789.74	Professional		$345.62	$1,528.39	$2,789.74
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $94.06 / $332.70 / $531.65	Professional	26	$94.06	$332.70	$531.65
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $257.18 / $1,318.47 / $2,459.04	Professional	TC	$257.18	$1,318.47	$2,459.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,439.68 / $1,439.68 / $2,334.63	Professional		$1,439.68	$1,439.68	$2,334.63
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $302.72 / $364.80 / $483.55	Professional	26	$302.72	$364.80	$483.55
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $913.53 / $1,740.46 / $2,070.10	Professional	TC	$913.53	$1,740.46	$2,070.10
United Facility/Professional Professional Modifier Low / Median / High Price $86.60 / $420.79 / $1,733.93	Professional		$86.60	$420.79	$1,733.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.48 / $162.47 / $291.61	Professional	26	$75.48	$162.47	$291.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $218.93 / $505.35 / $1,931.63	Professional	TC	$218.93	$505.35	$1,931.63