Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $144.54 / $186.21 / $275.42	Facility	26	$144.54	$186.21	$275.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $446.68 / $1,348.96	Professional		$204.17	$446.68	$1,348.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $134.90 / $363.08	Professional	26	$67.61	$134.90	$363.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $257.04 / $512.86	Professional	TC	$131.83	$257.04	$512.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $389.05 / $1,258.93	Professional		$199.53	$389.05	$1,258.93
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $104.71 / $389.05	Professional	26	$67.61	$104.71	$389.05
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $288.40 / $870.96	Professional	TC	$128.82	$288.40	$870.96
CareSource Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $154.88 / $251.19	Professional		$87.10	$154.88	$251.19
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $181.97 / $208.93 / $338.84	Facility	26	$181.97	$208.93	$338.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $588.84 / $812.83	Professional		$269.15	$588.84	$812.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $158.49 / $281.84	Professional	26	$63.10	$158.49	$281.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $436.52 / $562.34	Professional	TC	$186.21	$436.52	$562.34
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $436.52 / $707.95	Professional		$363.08	$436.52	$707.95
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $125.89 / $151.36 / $204.17	Professional	26	$125.89	$151.36	$204.17
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $288.40 / $524.81	Professional	TC	$239.88	$288.40	$524.81
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $645.65 / $645.65 / $645.65	Facility	26	$645.65	$645.65	$645.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $602.56 / $2,818.38	Professional		$263.03	$602.56	$2,818.38
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $162.18 / $575.44	Professional	26	$75.86	$162.18	$575.44
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $457.09 / $2,454.71	Professional	TC	$173.78	$457.09	$2,454.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $478.63	Professional		$32.36	$33.11	$478.63
Quartz Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $489.78 / $1,995.26	Professional		$251.19	$489.78	$1,995.26
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $158.49 / $630.96 / $630.96	Facility	26	$158.49	$630.96	$630.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $1,621.81 / $2,884.03	Professional		$316.23	$1,621.81	$2,884.03
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $363.08 / $575.44	Professional	26	$87.10	$363.08	$575.44
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $1,380.38 / $2,511.89	Professional	TC	$208.93	$1,380.38	$2,511.89
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,659.59 / $2,187.76	Professional		$1,202.26	$1,659.59	$2,187.76
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $302.00 / $416.87 / $537.03	Professional	26	$302.00	$416.87	$537.03
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $676.08 / $1,513.56 / $1,862.09	Professional	TC	$676.08	$1,513.56	$1,862.09
United Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $489.78 / $954.99	Professional		$239.88	$489.78	$954.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $120.23 / $269.15	Professional	26	$74.13	$120.23	$269.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $346.74 / $758.58	Professional	TC	$158.49	$346.74	$758.58