Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $213.71 / $237.93 / $273.61	Facility	26	$213.71	$237.93	$273.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $360.17 / $713.81 / $1,480.90	Professional		$360.17	$713.81	$1,480.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.04 / $237.93 / $830.80	Professional	26	$104.04	$237.93	$830.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $252.75 / $392.11 / $755.80	Professional	TC	$252.75	$392.11	$755.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $341.01 / $861.04 / $2,696.05	Professional		$341.01	$861.04	$2,696.05
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $99.14 / $235.72 / $775.83	Professional	26	$99.14	$235.72	$775.83
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $241.87 / $616.77 / $1,920.23	Professional	TC	$241.87	$616.77	$1,920.23
CareSource Facility/Professional Professional Modifier Low / Median / High Price $113.63 / $286.58 / $463.49	Professional		$113.63	$286.58	$463.49
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $265.83 / $310.64 / $412.87	Facility	26	$265.83	$310.64	$412.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $491.73 / $1,219.82 / $1,386.16	Professional		$491.73	$1,219.82	$1,386.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $115.92 / $355.76 / $404.28	Professional	26	$115.92	$355.76	$404.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $344.52 / $864.06 / $981.89	Professional	TC	$344.52	$864.06	$981.89
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $950.80 / $950.80 / $950.80	Facility	26	$950.80	$950.80	$950.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $490.78 / $1,287.33 / $5,978.92	Professional		$490.78	$1,287.33	$5,978.92
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $126.84 / $286.45 / $733.09	Professional	26	$126.84	$286.45	$733.09
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $353.37 / $926.90 / $5,438.76	Professional	TC	$353.37	$926.90	$5,438.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $80.83 / $207.99 / $615.87	Professional		$80.83	$207.99	$615.87
Quartz Facility/Professional Professional Modifier Low / Median / High Price $666.25 / $998.15 / $2,042.44	Professional		$666.25	$998.15	$2,042.44
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $241.68 / $950.80 / $950.80	Facility	26	$241.68	$950.80	$950.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $524.63 / $3,261.02 / $5,978.92	Professional		$524.63	$3,261.02	$5,978.92
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $149.84 / $528.50 / $733.09	Professional	26	$149.84	$528.50	$733.09
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $363.93 / $2,926.31 / $5,438.76	Professional	TC	$363.93	$2,926.31	$5,438.76
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,124.15 / $2,173.58 / $3,237.51	Professional		$2,124.15	$2,173.58	$3,237.51
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $455.18 / $578.22 / $770.15	Professional	26	$455.18	$578.22	$770.15
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,350.51 / $2,313.69 / $2,751.90	Professional	TC	$1,350.51	$2,313.69	$2,751.90
United Facility/Professional Professional Modifier Low / Median / High Price $430.37 / $1,019.30 / $2,119.06	Professional		$430.37	$1,019.30	$2,119.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $120.24 / $268.47 / $463.23	Professional	26	$120.24	$268.47	$463.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $309.87 / $718.04 / $1,917.45	Professional	TC	$309.87	$718.04	$1,917.45