Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $288.40 / $436.52	Facility		$87.10	$288.40	$436.52
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.55 / $15.14 / $22.39	Facility	26	$9.55	$15.14	$22.39
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $36.31 / $229.09 / $426.58	Facility	TC	$36.31	$229.09	$426.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $44.67 / $169.82	Professional		$25.12	$44.67	$169.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $13.49 / $53.70	Professional	26	$7.94	$13.49	$53.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $30.90 / $81.28	Professional	TC	$16.98	$30.90	$81.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $44.67 / $154.88	Professional		$28.18	$44.67	$154.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $13.49 / $45.71	Professional	26	$8.51	$13.49	$45.71
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $31.62 / $107.15	Professional	TC	$19.05	$31.62	$107.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $12.30 / $30.90 / $47.86	Facility		$12.30	$30.90	$47.86
CareSource Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $25.70 / $38.02	Professional		$11.22	$25.70	$38.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $95.50 / $151.36	Facility		$81.28	$95.50	$151.36
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.39 / $26.30 / $41.69	Facility	26	$22.39	$26.30	$41.69
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $58.88 / $69.18 / $109.65	Facility	TC	$58.88	$69.18	$109.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $64.57 / $123.03	Professional		$28.84	$64.57	$123.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $18.62 / $35.48	Professional	26	$9.33	$18.62	$35.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $45.71 / $87.10	Professional	TC	$19.50	$45.71	$87.10
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $53.70 / $331.13	Facility		$25.70	$53.70	$331.13
DeanCare Facility/Professional Facility Modifier TC Low / Median / High Price $234.42 / $288.40 / $380.19	Facility	TC	$234.42	$288.40	$380.19
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $66.07 / $89.13	Professional		$54.95	$66.07	$89.13
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $19.05 / $26.30	Professional	26	$16.22	$19.05	$26.30
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $46.77 / $64.57	Professional	TC	$38.90	$46.77	$64.57
Medica Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $162.18 / $263.03	Facility		$27.54	$162.18	$263.03
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $70.79 / $138.04	Facility	26	$70.79	$70.79	$138.04
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $120.23 / $229.09 / $363.08	Facility	TC	$120.23	$229.09	$363.08
Medica Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $53.70 / $194.98	Professional		$28.84	$53.70	$194.98
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $22.39 / $83.18	Professional	26	$9.77	$22.39	$83.18
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $34.67 / $138.04	Professional	TC	$19.50	$34.67	$138.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $70.79	Professional		$32.36	$33.11	$70.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $69.18 / $104.71	Professional		$38.90	$69.18	$104.71
Quartz Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $363.08 / $363.08	Facility		$69.18	$363.08	$363.08
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $20.42 / $70.79 / $70.79	Facility	26	$20.42	$70.79	$70.79
Quartz Facility/Professional Facility Modifier TC Low / Median / High Price $48.98 / $138.04 / $138.04	Facility	TC	$48.98	$138.04	$138.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $141.25 / $194.98	Professional		$32.36	$141.25	$194.98
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $44.67 / $54.95	Professional	26	$10.72	$44.67	$54.95
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $95.50 / $138.04	Professional	TC	$21.88	$95.50	$138.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $77.62 / $190.55	Professional		$52.48	$77.62	$190.55
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $19.95 / $25.12	Professional	26	$16.98	$19.95	$25.12
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $38.90 / $54.95	Professional	TC	$32.36	$38.90	$54.95
United Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $229.09 / $302.00	Facility		$229.09	$229.09	$302.00
United Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $41.69 / $102.33	Professional		$28.18	$41.69	$102.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $13.80 / $30.90	Professional	26	$9.33	$13.80	$30.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $28.18 / $69.18	Professional	TC	$19.05	$28.18	$69.18