Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $88.13 / $172.44 / $224.86	Facility	26	$88.13	$172.44	$224.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $193.50 / $366.43 / $2,099.69	Professional		$193.50	$366.43	$2,099.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $76.64 / $116.84 / $830.40	Professional	26	$76.64	$116.84	$830.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $102.91 / $197.08 / $616.00	Professional	TC	$102.91	$197.08	$616.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $183.22 / $434.63 / $1,433.66	Professional		$183.22	$434.63	$1,433.66
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $80.31 / $190.95 / $627.80	Professional	26	$80.31	$190.95	$627.80
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $102.91 / $242.81 / $805.86	Professional	TC	$102.91	$242.81	$805.86
CareSource Facility/Professional Professional Modifier Low / Median / High Price $91.60 / $125.02 / $267.16	Professional		$91.60	$125.02	$267.16
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $216.27 / $252.73 / $335.90	Facility	26	$216.27	$252.73	$335.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $254.64 / $660.77 / $750.88	Professional		$254.64	$660.77	$750.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $98.52 / $288.30 / $327.61	Professional	26	$98.52	$288.30	$327.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $143.76 / $372.43 / $423.21	Professional	TC	$143.76	$372.43	$423.21
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $706.80 / $770.72 / $1,738.60	Facility	26	$706.80	$770.72	$1,738.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $226.07 / $511.83 / $1,217.23	Professional		$226.07	$511.83	$1,217.23
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $102.15 / $258.31 / $910.50	Professional	26	$102.15	$258.31	$910.50
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $124.96 / $285.29 / $1,308.00	Professional	TC	$124.96	$285.29	$1,308.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $61.90 / $158.36 / $354.25	Professional		$61.90	$158.36	$354.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $265.58 / $440.94 / $799.00	Professional		$265.58	$440.94	$799.00
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $195.85 / $770.72 / $770.72	Facility	26	$195.85	$770.72	$770.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $278.30 / $968.80 / $1,217.23	Professional		$278.30	$968.80	$1,217.23
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $121.43 / $428.80 / $521.24	Professional	26	$121.43	$428.80	$521.24
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $156.87 / $540.00 / $1,308.00	Professional	TC	$156.87	$540.00	$1,308.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $578.25 / $1,177.42 / $1,177.42	Professional		$578.25	$1,177.42	$1,177.42
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $245.79 / $288.02 / $469.55	Professional	26	$245.79	$288.02	$469.55
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $309.67 / $364.32 / $818.24	Professional	TC	$309.67	$364.32	$818.24
United Facility/Professional Professional Modifier Low / Median / High Price $214.52 / $457.16 / $916.07	Professional		$214.52	$457.16	$916.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $93.63 / $208.39 / $403.78	Professional	26	$93.63	$208.39	$403.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $118.76 / $267.02 / $549.49	Professional	TC	$118.76	$267.02	$549.49