Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $144.16 / $161.72 / $185.98	Facility	26	$144.16	$161.72	$185.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $214.64 / $475.00 / $2,346.00	Professional		$214.64	$475.00	$2,346.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.41 / $175.59 / $799.00	Professional	26	$70.41	$175.59	$799.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $142.74 / $312.64 / $449.55	Professional	TC	$142.74	$312.64	$449.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $197.66 / $504.03 / $1,554.33	Professional		$197.66	$504.03	$1,554.33
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $67.39 / $160.22 / $527.07	Professional	26	$67.39	$160.22	$527.07
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $130.27 / $332.19 / $1,078.61	Professional	TC	$130.27	$332.19	$1,078.61
CareSource Facility/Professional Professional Modifier Low / Median / High Price $76.59 / $155.25 / $269.79	Professional		$76.59	$155.25	$269.79
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $180.22 / $210.61 / $279.91	Facility	26	$180.22	$210.61	$279.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $285.81 / $708.14 / $804.70	Professional		$285.81	$708.14	$804.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.26 / $241.90 / $274.89	Professional	26	$79.26	$241.90	$274.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $186.50 / $466.24 / $529.80	Professional	TC	$186.50	$466.24	$529.80
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $647.12 / $647.12 / $647.12	Facility	26	$647.12	$647.12	$647.12
Medica Facility/Professional Professional Modifier Low / Median / High Price $283.13 / $707.82 / $2,831.41	Professional		$283.13	$707.82	$2,831.41
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $86.53 / $195.42 / $579.54	Professional	26	$86.53	$195.42	$579.54
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $189.38 / $500.88 / $2,465.48	Professional	TC	$189.38	$500.88	$2,465.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.30 / $126.15 / $308.19	Professional		$54.30	$126.15	$308.19
Quartz Facility/Professional Professional Modifier Low / Median / High Price $386.75 / $579.41 / $2,014.28	Professional		$386.75	$579.41	$2,014.28
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $164.33 / $647.12 / $647.12	Facility	26	$164.33	$647.12	$647.12
Quartz Facility/Professional Professional Modifier Low / Median / High Price $304.51 / $1,552.22 / $2,831.41	Professional		$304.51	$1,552.22	$2,831.41
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $101.88 / $360.55 / $579.54	Professional	26	$101.88	$360.55	$579.54
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $216.01 / $1,325.29 / $2,465.48	Professional	TC	$216.01	$1,325.29	$2,465.48
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,255.88 / $1,261.82 / $2,115.69	Professional		$1,255.88	$1,261.82	$2,115.69
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $303.45 / $391.95 / $522.00	Professional	26	$303.45	$391.95	$522.00
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $731.06 / $1,521.58 / $1,809.77	Professional	TC	$731.06	$1,521.58	$1,809.77
United Facility/Professional Professional Modifier Low / Median / High Price $248.28 / $580.82 / $1,272.21	Professional		$248.28	$580.82	$1,272.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $77.23 / $165.13 / $316.02	Professional	26	$77.23	$165.13	$316.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $166.07 / $395.51 / $1,090.77	Professional	TC	$166.07	$395.51	$1,090.77