Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $92.42 / $180.83 / $2,710.06	Facility	26	$92.42	$180.83	$2,710.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $304.20 / $613.95 / $2,880.90	Professional		$304.20	$613.95	$2,880.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.96 / $182.94 / $862.08	Professional	26	$81.96	$182.94	$862.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $222.99 / $382.43 / $1,494.94	Professional	TC	$222.99	$382.43	$1,494.94
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $306.97 / $721.56 / $2,382.30	Professional		$306.97	$721.56	$2,382.30
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $83.99 / $199.69 / $659.23	Professional	26	$83.99	$199.69	$659.23
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $220.17 / $527.77 / $1,704.41	Professional	TC	$220.17	$527.77	$1,704.41
CareSource Facility/Professional Professional Modifier Low / Median / High Price $96.14 / $263.06 / $415.46	Professional		$96.14	$263.06	$415.46
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $226.18 / $264.31 / $351.29	Facility	26	$226.18	$264.31	$351.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $400.67 / $1,096.14 / $1,245.60	Professional		$400.67	$1,096.14	$1,245.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $103.15 / $301.63 / $342.76	Professional	26	$103.15	$301.63	$342.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $296.14 / $794.51 / $902.85	Professional	TC	$296.14	$794.51	$902.85
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $765.70 / $805.76 / $1,329.07	Facility	26	$765.70	$805.76	$1,329.07
Medica Facility/Professional Professional Modifier Low / Median / High Price $366.79 / $837.47 / $2,077.84	Professional		$366.79	$837.47	$2,077.84
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $108.03 / $325.39 / $1,001.60	Professional	26	$108.03	$325.39	$1,001.60
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $259.61 / $588.59 / $2,614.00	Professional	TC	$259.61	$588.59	$2,614.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $80.47 / $206.50 / $542.83	Professional		$80.47	$206.50	$542.83
Quartz Facility/Professional Professional Modifier Low / Median / High Price $506.53 / $726.39 / $1,325.43	Professional		$506.53	$726.39	$1,325.43
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $204.90 / $805.76 / $805.76	Facility	26	$204.90	$805.76	$805.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $461.67 / $1,581.45 / $2,077.84	Professional		$461.67	$1,581.45	$2,077.84
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $127.04 / $450.10 / $547.02	Professional	26	$127.04	$450.10	$547.02
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $334.62 / $1,131.40 / $2,614.00	Professional	TC	$334.62	$1,131.40	$2,614.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $989.25 / $1,953.19 / $1,953.19	Professional		$989.25	$1,953.19	$1,953.19
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $257.93 / $301.04 / $490.84	Professional	26	$257.93	$301.04	$490.84
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $601.38 / $707.50 / $1,445.72	Professional	TC	$601.38	$707.50	$1,445.72
United Facility/Professional Professional Modifier Low / Median / High Price $351.51 / $660.03 / $1,386.14	Professional		$351.51	$660.03	$1,386.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $98.26 / $210.31 / $394.51	Professional	26	$98.26	$210.31	$394.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $238.92 / $545.30 / $1,047.97	Professional	TC	$238.92	$545.30	$1,047.97