Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.54 / $280.73 / $439.39	Facility		$89.54	$280.73	$439.39
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.11 / $18.23 / $18.35	Facility	26	$13.11	$18.23	$18.35
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $36.33 / $243.66 / $395.72	Facility	TC	$36.33	$243.66	$395.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.71 / $60.52 / $252.12	Professional		$26.71	$60.52	$252.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.22 / $20.07 / $88.82	Professional	26	$8.22	$20.07	$88.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.21 / $31.60 / $138.66	Professional	TC	$18.21	$31.60	$138.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.97 / $58.97 / $169.99	Professional		$27.97	$58.97	$169.99
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.46 / $19.54 / $54.44	Professional	26	$8.46	$19.54	$54.44
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $41.67 / $116.95	Professional	TC	$19.05	$41.67	$116.95
CareSource Facility/Professional Facility Modifier Low / Median / High Price $9.03 / $24.57 / $36.78	Facility		$9.03	$24.57	$36.78
CareSource Facility/Professional Professional Modifier Low / Median / High Price $9.68 / $25.52 / $40.52	Professional		$9.68	$25.52	$40.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $82.00 / $95.83 / $127.36	Facility		$82.00	$95.83	$127.36
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.53 / $26.33 / $34.99	Facility	26	$22.53	$26.33	$34.99
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $59.47 / $69.50 / $92.37	Facility	TC	$59.47	$69.50	$92.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.76 / $106.10 / $120.56	Professional		$31.76	$106.10	$120.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.35 / $30.66 / $34.84	Professional	26	$10.35	$30.66	$34.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.22 / $75.44 / $85.73	Professional	TC	$21.22	$75.44	$85.73
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $26.03 / $35.47 / $58.46	Facility		$26.03	$35.47	$58.46
Medica Facility/Professional Facility Modifier Low / Median / High Price $26.03 / $58.46 / $266.64	Facility		$26.03	$58.46	$266.64
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $70.00 / $70.00 / $139.00	Facility	26	$70.00	$70.00	$139.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $96.88 / $230.85 / $357.90	Facility	TC	$96.88	$230.85	$357.90
Medica Facility/Professional Professional Modifier Low / Median / High Price $30.93 / $72.70 / $193.62	Professional		$30.93	$72.70	$193.62
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.29 / $25.96 / $82.80	Professional	26	$10.29	$25.96	$82.80
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $20.62 / $47.60 / $138.27	Professional	TC	$20.62	$47.60	$138.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.34 / $33.09 / $73.87	Professional		$19.34	$33.09	$73.87
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $26.03 / $39.60 / $58.46	Facility		$26.03	$39.60	$58.46
Quartz Facility/Professional Professional Modifier Low / Median / High Price $52.71 / $70.98 / $116.51	Professional		$52.71	$70.98	$116.51
Quartz Facility/Professional Facility Modifier Low / Median / High Price $72.08 / $342.77 / $342.77	Facility		$72.08	$342.77	$342.77
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $20.83 / $70.00 / $70.00	Facility	26	$20.83	$70.00	$70.00
Quartz Facility/Professional Facility Modifier TC Low / Median / High Price $51.25 / $96.88 / $96.88	Facility	TC	$51.25	$96.88	$96.88
Quartz Facility/Professional Professional Modifier Low / Median / High Price $44.69 / $139.80 / $193.62	Professional		$44.69	$139.80	$193.62
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $13.51 / $45.05 / $55.28	Professional	26	$13.51	$45.05	$55.28
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $31.77 / $94.75 / $138.27	Professional	TC	$31.77	$94.75	$138.27
Security Health Facility/Professional Professional Modifier Low / Median / High Price $52.70 / $189.06 / $189.06	Professional		$52.70	$189.06	$189.06
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.05 / $20.05 / $41.23	Professional	26	$17.05	$20.05	$41.23
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $32.72 / $38.50 / $94.15	Professional	TC	$32.72	$38.50	$94.15
United Facility/Professional Professional Modifier Low / Median / High Price $29.59 / $65.66 / $122.68	Professional		$29.59	$65.66	$122.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.56 / $50.26 / $87.90	Professional	26	$15.56	$50.26	$87.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.21 / $44.50 / $83.04	Professional	TC	$20.21	$44.50	$83.04