Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $109.61 / $117.77 / $117.77	Facility	26	$109.61	$117.77	$117.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $148.32 / $268.77 / $860.33	Professional		$148.32	$268.77	$860.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.43 / $95.20 / $635.54	Professional	26	$54.43	$95.20	$635.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $89.92 / $164.40 / $250.31	Professional	TC	$89.92	$164.40	$250.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $137.01 / $324.79 / $1,073.85	Professional		$137.01	$324.79	$1,073.85
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $54.81 / $130.32 / $431.53	Professional	26	$54.81	$130.32	$431.53
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $82.20 / $194.00 / $642.33	Professional	TC	$82.20	$194.00	$642.33
CareSource Facility/Professional Professional Modifier Low / Median / High Price $62.52 / $98.71 / $188.88	Professional		$62.52	$98.71	$188.88
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $147.78 / $172.70 / $229.53	Facility	26	$147.78	$172.70	$229.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $195.74 / $493.28 / $560.54	Professional		$195.74	$493.28	$560.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.37 / $197.44 / $224.36	Professional	26	$64.37	$197.44	$224.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $118.68 / $295.85 / $336.19	Professional	TC	$118.68	$295.85	$336.19
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $527.60 / $527.60 / $527.60	Facility	26	$527.60	$527.60	$527.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $173.34 / $435.24 / $1,561.56	Professional		$173.34	$435.24	$1,561.56
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $67.01 / $155.09 / $386.35	Professional	26	$67.01	$155.09	$386.35
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $102.89 / $278.64 / $1,649.00	Professional	TC	$102.89	$278.64	$1,649.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.20 / $102.71 / $250.42	Professional		$38.20	$102.71	$250.42
Quartz Facility/Professional Professional Modifier Low / Median / High Price $269.75 / $404.13 / $806.12	Professional		$269.75	$404.13	$806.12
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $134.13 / $527.60 / $527.60	Facility	26	$134.13	$527.60	$527.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $228.54 / $863.47 / $1,561.56	Professional		$228.54	$863.47	$1,561.56
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $83.16 / $293.55 / $386.35	Professional	26	$83.16	$293.55	$386.35
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $126.05 / $678.53 / $1,649.00	Professional	TC	$126.05	$678.53	$1,649.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $485.37 / $878.96 / $878.96	Professional		$485.37	$878.96	$878.96
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $196.56 / $212.42 / $321.13	Professional	26	$196.56	$212.42	$321.13
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $288.82 / $365.44 / $675.49	Professional	TC	$288.82	$365.44	$675.49
United Facility/Professional Professional Modifier Low / Median / High Price $167.77 / $381.58 / $718.98	Professional		$167.77	$381.58	$718.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.09 / $142.75 / $283.64	Professional	26	$64.09	$142.75	$283.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $98.38 / $226.49 / $508.93	Professional	TC	$98.38	$226.49	$508.93