Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $161.37 / $161.37 / $180.15	Facility	26	$161.37	$161.37	$180.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $346.23 / $761.68 / $2,129.21	Professional		$346.23	$761.68	$2,129.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.79 / $180.15 / $841.50	Professional	26	$78.79	$180.15	$841.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $253.09 / $348.53 / $697.83	Professional	TC	$253.09	$348.53	$697.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $317.37 / $779.07 / $2,519.42	Professional		$317.37	$779.07	$2,519.42
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $75.06 / $178.48 / $590.72	Professional	26	$75.06	$178.48	$590.72
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $242.30 / $605.41 / $1,928.70	Professional	TC	$242.30	$605.41	$1,928.70
CareSource Facility/Professional Professional Modifier Low / Median / High Price $85.67 / $278.98 / $429.00	Professional		$85.67	$278.98	$429.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $200.95 / $234.83 / $312.10	Facility	26	$200.95	$234.83	$312.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $456.18 / $1,134.93 / $1,289.69	Professional		$456.18	$1,134.93	$1,289.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.72 / $269.69 / $306.45	Professional	26	$87.72	$269.69	$306.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $345.00 / $865.24 / $983.23	Professional	TC	$345.00	$865.24	$983.23
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $720.40 / $720.40 / $720.40	Facility	26	$720.40	$720.40	$720.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $459.68 / $1,025.44 / $3,348.15	Professional		$459.68	$1,025.44	$3,348.15
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $96.48 / $217.88 / $597.70	Professional	26	$96.48	$217.88	$597.70
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $355.16 / $859.02 / $2,941.88	Professional	TC	$355.16	$859.02	$2,941.88
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 $617.50 / $925.11 / $1,459.46	Professional		$617.50	$925.11	$1,459.46
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $183.20 / $720.40 / $720.40	Facility	26	$183.20	$720.40	$720.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $478.01 / $1,834.75 / $3,348.15	Professional		$478.01	$1,834.75	$3,348.15
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $113.59 / $402.00 / $597.70	Professional	26	$113.59	$402.00	$597.70
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $364.42 / $1,582.85 / $2,941.88	Professional	TC	$364.42	$1,582.85	$2,941.88
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,881.39 / $2,022.32 / $2,482.73	Professional		$1,881.39	$2,022.32	$2,482.73
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $364.14 / $441.50 / $582.03	Professional	26	$364.14	$441.50	$582.03
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,352.40 / $1,757.13 / $2,089.92	Professional	TC	$1,352.40	$1,757.13	$2,089.92
United Facility/Professional Professional Modifier Low / Median / High Price $386.66 / $899.03 / $1,633.94	Professional		$386.66	$899.03	$1,633.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $91.08 / $201.00 / $352.35	Professional	26	$91.08	$201.00	$352.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $311.44 / $710.67 / $1,533.50	Professional	TC	$311.44	$710.67	$1,533.50