Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $184.71 / $198.86 / $258.58	Facility	26	$184.71	$198.86	$258.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $374.33 / $687.99 / $3,969.50	Professional		$374.33	$687.99	$3,969.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.31 / $201.60 / $1,071.00	Professional	26	$90.31	$201.60	$1,071.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $248.37 / $396.51 / $649.67	Professional	TC	$248.37	$396.51	$649.67
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $344.00 / $809.69 / $2,679.01	Professional		$344.00	$809.69	$2,679.01
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $92.36 / $219.60 / $725.07	Professional	26	$92.36	$219.60	$725.07
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $251.33 / $596.54 / $1,934.01	Professional	TC	$251.33	$596.54	$1,934.01
CareSource Facility/Professional Professional Modifier Low / Median / High Price $105.67 / $296.93 / $465.18	Professional		$105.67	$296.93	$465.18
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $248.71 / $290.64 / $386.28	Facility	26	$248.71	$290.64	$386.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $463.92 / $1,229.25 / $1,396.88	Professional		$463.92	$1,229.25	$1,396.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $114.47 / $332.35 / $377.68	Professional	26	$114.47	$332.35	$377.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $334.56 / $896.90 / $1,019.20	Professional	TC	$334.56	$896.90	$1,019.20
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $887.84 / $887.84 / $2,506.00	Facility	26	$887.84	$887.84	$2,506.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $412.34 / $925.25 / $2,326.86	Professional		$412.34	$925.25	$2,326.86
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $117.12 / $268.10 / $600.70	Professional	26	$117.12	$268.10	$600.70
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $302.70 / $678.26 / $2,909.00	Professional	TC	$302.70	$678.26	$2,909.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $80.83 / $207.99 / $601.90	Professional		$80.83	$207.99	$601.90
Quartz Facility/Professional Professional Modifier Low / Median / High Price $668.85 / $813.14 / $1,486.39	Professional		$668.85	$813.14	$1,486.39
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $225.78 / $887.84 / $887.84	Facility	26	$225.78	$887.84	$887.84
Quartz Facility/Professional Professional Modifier Low / Median / High Price $517.73 / $1,778.45 / $2,326.86	Professional		$517.73	$1,778.45	$2,326.86
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $139.97 / $494.65 / $600.70	Professional	26	$139.97	$494.65	$600.70
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $377.75 / $1,283.80 / $2,909.00	Professional	TC	$377.75	$1,283.80	$2,909.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,062.55 / $2,190.38 / $2,190.38	Professional		$1,062.55	$2,190.38	$2,190.38
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $285.24 / $332.33 / $543.30	Professional	26	$285.24	$332.33	$543.30
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $690.33 / $812.15 / $1,723.73	Professional	TC	$690.33	$812.15	$1,723.73
United Facility/Professional Professional Modifier Low / Median / High Price $395.16 / $857.21 / $1,770.41	Professional		$395.16	$857.21	$1,770.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $108.13 / $247.33 / $576.51	Professional	26	$108.13	$247.33	$576.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $282.30 / $618.79 / $1,278.00	Professional	TC	$282.30	$618.79	$1,278.00