Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $128.57 / $128.57 / $138.16	Facility	26	$128.57	$128.57	$138.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $256.52 / $470.88 / $1,448.93	Professional		$256.52	$470.88	$1,448.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.09 / $117.95 / $491.92	Professional	26	$64.09	$117.95	$491.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $170.44 / $342.31 / $720.73	Professional	TC	$170.44	$342.31	$720.73
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $264.74 / $618.37 / $2,027.37	Professional		$264.74	$618.37	$2,027.37
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $64.28 / $152.85 / $506.02	Professional	26	$64.28	$152.85	$506.02
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $197.83 / $470.08 / $1,508.35	Professional	TC	$197.83	$470.08	$1,508.35
CareSource Facility/Professional Professional Modifier Low / Median / High Price $73.37 / $229.54 / $356.57	Professional		$73.37	$229.54	$356.57
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $173.02 / $202.18 / $268.72	Facility	26	$173.02	$202.18	$268.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $361.79 / $946.57 / $1,075.65	Professional		$361.79	$946.57	$1,075.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $76.19 / $231.78 / $263.39	Professional	26	$76.19	$231.78	$263.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $273.00 / $714.76 / $812.23	Professional	TC	$273.00	$714.76	$812.23
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $619.20 / $619.20 / $1,189.00	Facility	26	$619.20	$619.20	$1,189.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $323.00 / $742.36 / $2,385.40	Professional		$323.00	$742.36	$2,385.40
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $79.06 / $182.59 / $533.30	Professional	26	$79.06	$182.59	$533.30
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $240.30 / $576.87 / $2,603.00	Professional	TC	$240.30	$576.87	$2,603.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.30 / $147.33 / $429.56	Professional		$54.30	$147.33	$429.56
Quartz Facility/Professional Professional Modifier Low / Median / High Price $512.85 / $751.13 / $1,187.43	Professional		$512.85	$751.13	$1,187.43
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $157.44 / $619.20 / $619.20	Facility	26	$157.44	$619.20	$619.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $398.67 / $1,276.46 / $2,385.40	Professional		$398.67	$1,276.46	$2,385.40
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $97.62 / $344.60 / $533.30	Professional	26	$97.62	$344.60	$533.30
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $301.05 / $1,045.82 / $2,603.00	Professional	TC	$301.05	$1,045.82	$2,603.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $849.66 / $1,527.87 / $1,527.87	Professional		$849.66	$1,527.87	$1,527.87
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $231.38 / $242.76 / $378.34	Professional	26	$231.38	$242.76	$378.34
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $618.27 / $782.30 / $1,423.16	Professional	TC	$618.27	$782.30	$1,423.16
United Facility/Professional Professional Modifier Low / Median / High Price $311.89 / $683.21 / $1,339.76	Professional		$311.89	$683.21	$1,339.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.52 / $169.44 / $285.94	Professional	26	$75.52	$169.44	$285.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $229.76 / $520.90 / $1,089.46	Professional	TC	$229.76	$520.90	$1,089.46