Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $109.65 / $117.49 / $186.21	Facility	26	$109.65	$117.49	$186.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $245.47 / $812.83	Professional		$141.25	$245.47	$812.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $91.20 / $213.80	Professional	26	$53.70	$91.20	$213.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $120.23 / $239.88	Professional	TC	$81.28	$120.23	$239.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $218.78 / $794.33	Professional		$138.04	$218.78	$794.33
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $85.11 / $323.59	Professional	26	$54.95	$85.11	$323.59
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $151.36 / $478.63	Professional	TC	$81.28	$151.36	$478.63
CareSource Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $100.00 / $186.21	Professional		$70.79	$100.00	$186.21
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $147.91 / $173.78 / $275.42	Facility	26	$147.91	$173.78	$275.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $380.19 / $575.44	Professional		$141.25	$380.19	$575.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $117.49 / $229.09	Professional	26	$51.29	$117.49	$229.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $245.47 / $346.74	Professional	TC	$87.10	$245.47	$346.74
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $309.03 / $416.87	Professional		$257.04	$309.03	$416.87
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $125.89 / $169.82	Professional	26	$102.33	$125.89	$169.82
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $181.97 / $251.19	Professional	TC	$151.36	$181.97	$251.19
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $524.81 / $524.81 / $524.81	Facility	26	$524.81	$524.81	$524.81
Medica Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $363.08 / $1,548.82	Professional		$173.78	$363.08	$1,548.82
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $128.82 / $389.05	Professional	26	$61.66	$128.82	$389.05
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $223.87 / $1,659.59	Professional	TC	$102.33	$223.87	$1,659.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $229.09	Professional		$32.36	$33.11	$229.09
Quartz Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $346.74 / $812.83	Professional		$177.83	$346.74	$812.83
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $131.83 / $512.86 / $512.86	Facility	26	$131.83	$512.86	$512.86
Quartz Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $912.01 / $1,621.81	Professional		$213.80	$912.01	$1,621.81
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $295.12 / $389.05	Professional	26	$70.79	$295.12	$389.05
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $707.95 / $1,659.59	Professional	TC	$125.89	$707.95	$1,659.59
Security Health Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $794.33 / $1,023.29	Professional		$489.78	$794.33	$1,023.29
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $194.98 / $213.80 / $269.15	Professional	26	$194.98	$213.80	$269.15
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $346.74 / $575.44	Professional	TC	$288.40	$346.74	$575.44
United Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $269.15 / $588.84	Professional		$151.36	$269.15	$588.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $93.33 / $213.80	Professional	26	$60.26	$93.33	$213.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $173.78 / $416.87	Professional	TC	$91.20	$173.78	$416.87