Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $201.23 / $216.88 / $216.88	Facility	26	$201.23	$216.88	$216.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $416.50 / $693.19 / $2,348.94	Professional		$416.50	$693.19	$2,348.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $96.39 / $201.23 / $1,164.50	Professional	26	$96.39	$201.23	$1,164.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $277.89 / $503.89 / $704.14	Professional	TC	$277.89	$503.89	$704.14
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $382.09 / $882.28 / $2,947.39	Professional		$382.09	$882.28	$2,947.39
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $100.62 / $231.48 / $787.46	Professional	26	$100.62	$231.48	$787.46
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $281.47 / $657.66 / $2,136.11	Professional	TC	$281.47	$657.66	$2,136.11
CareSource Facility/Professional Professional Modifier Low / Median / High Price $115.40 / $336.60 / $522.32	Professional		$115.40	$336.60	$522.32
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $271.24 / $316.95 / $421.27	Facility	26	$271.24	$316.95	$421.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $520.22 / $1,372.15 / $1,559.26	Professional		$520.22	$1,372.15	$1,559.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $122.98 / $362.31 / $411.71	Professional	26	$122.98	$362.31	$411.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $380.11 / $1,009.83 / $1,147.54	Professional	TC	$380.11	$1,009.83	$1,147.54
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $969.20 / $969.20 / $969.20	Facility	26	$969.20	$969.20	$969.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $469.58 / $1,045.51 / $2,573.48	Professional		$469.58	$1,045.51	$2,573.48
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $125.90 / $291.95 / $653.20	Professional	26	$125.90	$291.95	$653.20
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $340.30 / $768.53 / $2,038.19	Professional	TC	$340.30	$768.53	$2,038.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $80.83 / $231.39 / $662.23	Professional		$80.83	$231.39	$662.23
Quartz Facility/Professional Professional Modifier Low / Median / High Price $752.05 / $918.60 / $1,659.18	Professional		$752.05	$918.60	$1,659.18
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $246.13 / $969.20 / $969.20	Facility	26	$246.13	$969.20	$969.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $577.91 / $1,956.60 / $2,573.48	Professional		$577.91	$1,956.60	$2,573.48
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $152.59 / $538.65 / $653.20	Professional	26	$152.59	$538.65	$653.20
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $425.33 / $1,417.95 / $2,038.19	Professional	TC	$425.33	$1,417.95	$2,038.19
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,192.81 / $2,444.96 / $2,444.96	Professional		$1,192.81	$2,444.96	$2,444.96
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $361.87 / $409.66 / $592.02	Professional	26	$361.87	$409.66	$592.02
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $762.28 / $896.80 / $2,212.17	Professional	TC	$762.28	$896.80	$2,212.17
United Facility/Professional Professional Modifier Low / Median / High Price $434.82 / $951.49 / $1,947.76	Professional		$434.82	$951.49	$1,947.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $117.63 / $251.73 / $472.13	Professional	26	$117.63	$251.73	$472.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $325.39 / $708.97 / $1,580.26	Professional	TC	$325.39	$708.97	$1,580.26