Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $117.49 / $125.89 / $199.53	Facility	26	$117.49	$125.89	$199.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $389.05 / $1,230.27	Professional		$234.42	$389.05	$1,230.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $109.65 / $309.03	Professional	26	$57.54	$109.65	$309.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $229.09 / $467.74	Professional	TC	$162.18	$229.09	$467.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $363.08 / $1,288.25	Professional		$234.42	$363.08	$1,288.25
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $91.20 / $346.74	Professional	26	$58.88	$91.20	$346.74
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $275.42 / $977.24	Professional	TC	$173.78	$275.42	$977.24
CareSource Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $208.93 / $295.12	Professional		$75.86	$208.93	$295.12
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $158.49 / $186.21 / $295.12	Facility	26	$158.49	$186.21	$295.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $524.81 / $977.24	Professional		$234.42	$524.81	$977.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $125.89 / $245.47	Professional	26	$54.95	$125.89	$245.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $398.11 / $724.44	Professional	TC	$169.82	$398.11	$724.44
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $512.86 / $707.95	Professional		$436.52	$512.86	$707.95
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $131.83 / $177.83	Professional	26	$109.65	$131.83	$177.83
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $380.19 / $524.81	Professional	TC	$323.59	$380.19	$524.81
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $562.34 / $562.34 / $562.34	Facility	26	$562.34	$562.34	$562.34
Medica Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $562.34 / $1,862.09	Professional		$288.40	$562.34	$1,862.09
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $134.90 / $446.68	Professional	26	$64.57	$134.90	$446.68
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $426.58 / $2,089.30	Professional	TC	$208.93	$426.58	$2,089.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $338.84	Professional		$32.36	$33.11	$338.84
Quartz Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $588.84 / $1,096.48	Professional		$302.00	$588.84	$1,096.48
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $141.25 / $549.54 / $549.54	Facility	26	$141.25	$549.54	$549.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $1,174.90 / $1,905.46	Professional		$338.84	$1,174.90	$1,905.46
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $316.23 / $446.68	Professional	26	$75.86	$316.23	$446.68
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $870.96 / $2,089.30	Professional	TC	$239.88	$870.96	$2,089.30
Security Health Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $1,148.15 / $1,584.89	Professional		$741.31	$1,148.15	$1,584.89
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $208.93 / $223.87 / $281.84	Professional	26	$208.93	$223.87	$281.84
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $537.03 / $645.65 / $870.96	Professional	TC	$537.03	$645.65	$870.96
United Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $407.38 / $891.25	Professional		$251.19	$407.38	$891.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $100.00 / $229.09	Professional	26	$64.57	$100.00	$229.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $309.03 / $676.08	Professional	TC	$186.21	$309.03	$676.08