Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $162.18 / $181.97 / $251.19	Facility	26	$162.18	$181.97	$251.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $489.78 / $1,096.48	Professional		$173.78	$489.78	$1,096.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $162.18 / $512.86	Professional	26	$81.28	$162.18	$512.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $338.84 / $616.60	Professional	TC	$245.47	$338.84	$616.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $524.81 / $1,862.09	Professional		$316.23	$524.81	$1,862.09
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $117.49 / $436.52	Professional	26	$75.86	$117.49	$436.52
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $398.11 / $1,412.54	Professional	TC	$239.88	$398.11	$1,412.54
CareSource Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $288.40 / $389.05	Professional		$97.72	$288.40	$389.05
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $199.53 / $234.42 / $371.54	Facility	26	$199.53	$234.42	$371.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $831.76 / $1,318.26	Professional		$346.74	$831.76	$1,318.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $177.83 / $309.03	Professional	26	$70.79	$177.83	$309.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $616.60 / $1,000.00	Professional	TC	$269.15	$616.60	$1,000.00
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $707.95 / $977.24	Professional		$588.84	$707.95	$977.24
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $141.25 / $169.82 / $229.09	Professional	26	$141.25	$169.82	$229.09
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $446.68 / $524.81 / $758.58	Professional	TC	$446.68	$524.81	$758.58
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $724.44 / $724.44 / $724.44	Facility	26	$724.44	$724.44	$724.44
Medica Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $870.96 / $3,311.31	Professional		$426.58	$870.96	$3,311.31
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $186.21 / $602.56	Professional	26	$83.18	$186.21	$602.56
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $331.13 / $676.08 / $2,951.21	Professional	TC	$331.13	$676.08	$2,951.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $562.34	Professional		$32.36	$33.11	$562.34
Quartz Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $794.33 / $1,412.54	Professional		$407.38	$794.33	$1,412.54
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $177.83 / $707.95 / $707.95	Facility	26	$177.83	$707.95	$707.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $1,905.46 / $3,467.37	Professional		$457.09	$1,905.46	$3,467.37
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $398.11 / $602.56	Professional	26	$95.50	$398.11	$602.56
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $363.08 / $1,659.59 / $3,019.95	Professional	TC	$363.08	$1,659.59	$3,019.95
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $2,041.74 / $2,818.38	Professional		$1,819.70	$2,041.74	$2,818.38
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $363.08 / $467.74 / $602.56	Professional	26	$363.08	$467.74	$602.56
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,288.25 / $1,737.80 / $2,137.96	Professional	TC	$1,288.25	$1,737.80	$2,137.96
United Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $645.65 / $1,348.96	Professional		$380.19	$645.65	$1,348.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $134.90 / $295.12	Professional	26	$83.18	$134.90	$295.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $524.81 / $1,122.02	Professional	TC	$295.12	$524.81	$1,122.02