Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $134.53 / $150.21 / $3,027.61	Facility	26	$134.53	$150.21	$3,027.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $196.00 / $546.25 / $2,414.00	Professional		$196.00	$546.25	$2,414.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.63 / $189.00 / $768.96	Professional	26	$66.63	$189.00	$768.96
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $310.35 / $310.35 / $310.35	Professional	50	$310.35	$310.35	$310.35
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $107.51 / $166.50 / $287.51	Professional	52	$107.51	$166.50	$287.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $155.66 / $338.15 / $972.99	Professional	TC	$155.66	$338.15	$972.99
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $203.48 / $508.68 / $1,596.18	Professional		$203.48	$508.68	$1,596.18
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $62.59 / $148.82 / $492.66	Professional	26	$62.59	$148.82	$492.66
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $305.22 / $778.53 / $2,394.27	Professional	50	$305.22	$778.53	$2,394.27
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $140.90 / $341.40 / $1,103.52	Professional	TC	$140.90	$341.40	$1,103.52
CareSource Facility/Professional Professional Modifier Low / Median / High Price $71.42 / $170.42 / $280.11	Professional		$71.42	$170.42	$280.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $168.51 / $196.92 / $261.72	Facility	26	$168.51	$196.92	$261.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $297.08 / $732.94 / $832.89	Professional		$297.08	$732.94	$832.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.17 / $225.67 / $256.44	Professional	26	$72.17	$225.67	$256.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $204.42 / $507.28 / $576.45	Professional	TC	$204.42	$507.28	$576.45
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $603.28 / $603.28 / $1,851.19	Facility	26	$603.28	$603.28	$1,851.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $287.61 / $741.60 / $2,791.06	Professional		$287.61	$741.60	$2,791.06
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $80.27 / $209.35 / $556.80	Professional	26	$80.27	$209.35	$556.80
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $200.65 / $526.33 / $2,451.15	Professional	TC	$200.65	$526.33	$2,451.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.30 / $126.60 / $368.75	Professional		$54.30	$126.60	$368.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $402.35 / $602.78 / $2,083.82	Professional		$402.35	$602.78	$2,083.82
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $153.30 / $603.28 / $603.28	Facility	26	$153.30	$603.28	$603.28
Quartz Facility/Professional Professional Modifier Low / Median / High Price $348.53 / $1,528.39 / $2,791.06	Professional		$348.53	$1,528.39	$2,791.06
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $95.04 / $334.45 / $525.38	Professional	26	$95.04	$334.45	$525.38
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $213.65 / $1,318.47 / $2,451.15	Professional	TC	$213.65	$1,318.47	$2,451.15
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,289.04 / $2,817.00 / $2,817.00	Professional		$1,289.04	$2,817.00	$2,817.00
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $304.76 / $836.08 / $836.08	Professional	26	$304.76	$836.08	$836.08
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $911.86 / $1,980.92 / $1,980.92	Professional	TC	$911.86	$1,980.92	$1,980.92
United Facility/Professional Professional Modifier Low / Median / High Price $249.66 / $597.35 / $1,241.83	Professional		$249.66	$597.35	$1,241.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $76.30 / $168.45 / $293.14	Professional	26	$76.30	$168.45	$293.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $175.96 / $416.75 / $1,120.71	Professional	TC	$175.96	$416.75	$1,120.71