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 $403.98 / $661.50 / $2,205.75	Professional		$403.98	$661.50	$2,205.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.04 / $237.93 / $722.50	Professional	26	$104.04	$237.93	$722.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $304.85 / $422.10 / $783.89	Professional	TC	$304.85	$422.10	$783.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $390.91 / $957.74 / $3,103.62	Professional		$390.91	$957.74	$3,103.62
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 $291.77 / $728.93 / $2,327.79	Professional	TC	$291.77	$728.93	$2,327.79
CareSource Facility/Professional Professional Modifier Low / Median / High Price $113.63 / $333.65 / $527.01	Professional		$113.63	$333.65	$527.01
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $266.73 / $311.70 / $414.27	Facility	26	$266.73	$311.70	$414.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $559.87 / $1,395.70 / $1,586.03	Professional		$559.87	$1,395.70	$1,586.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $115.66 / $356.94 / $405.61	Professional	26	$115.66	$356.94	$405.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $412.66 / $1,038.76 / $1,180.41	Professional	TC	$412.66	$1,038.76	$1,180.41
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $953.92 / $953.92 / $953.92	Facility	26	$953.92	$953.92	$953.92
Medica Facility/Professional Professional Modifier Low / Median / High Price $567.36 / $1,372.27 / $5,981.06	Professional		$567.36	$1,372.27	$5,981.06
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $127.25 / $287.37 / $883.52	Professional	26	$127.25	$287.37	$883.52
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $429.51 / $1,060.88 / $5,438.76	Professional	TC	$429.51	$1,060.88	$5,438.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $80.83 / $256.26 / $679.60	Professional		$80.83	$256.26	$679.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $758.55 / $1,136.42 / $2,455.46	Professional		$758.55	$1,136.42	$2,455.46
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $242.48 / $953.92 / $953.92	Facility	26	$242.48	$953.92	$953.92
Quartz Facility/Professional Professional Modifier Low / Median / High Price $587.83 / $3,262.16 / $5,981.06	Professional		$587.83	$3,262.16	$5,981.06
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $150.34 / $530.20 / $883.52	Professional	26	$150.34	$530.20	$883.52
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $437.50 / $2,926.31 / $5,438.76	Professional	TC	$437.50	$2,926.31	$5,438.76
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,124.15 / $2,486.96 / $3,030.86	Professional		$2,124.15	$2,486.96	$3,030.86
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $455.18 / $580.09 / $770.15	Professional	26	$455.18	$580.09	$770.15
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,570.80 / $2,126.09 / $2,528.77	Professional	TC	$1,570.80	$2,126.09	$2,528.77
United Facility/Professional Professional Modifier Low / Median / High Price $523.72 / $1,110.61 / $2,449.73	Professional		$523.72	$1,110.61	$2,449.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $86.60 / $170.24 / $625.00	Professional	26	$86.60	$170.24	$625.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $396.47 / $872.76 / $1,908.24	Professional	TC	$396.47	$872.76	$1,908.24