Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $111.43 / $218.03 / $279.18	Facility	26	$111.43	$218.03	$279.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $361.35 / $733.88 / $3,973.85	Professional		$361.35	$733.88	$3,973.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $101.15 / $248.36 / $1,171.34	Professional	26	$101.15	$248.36	$1,171.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $251.74 / $414.64 / $1,020.25	Professional	TC	$251.74	$414.64	$1,020.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $342.06 / $872.26 / $2,701.86	Professional		$342.06	$872.26	$2,701.86
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $101.15 / $240.52 / $791.71	Professional	26	$101.15	$240.52	$791.71
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $240.91 / $614.30 / $1,910.16	Professional	TC	$240.91	$614.30	$1,910.16
CareSource Facility/Professional Professional Modifier Low / Median / High Price $115.93 / $285.39 / $465.03	Professional		$115.93	$285.39	$465.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $272.14 / $318.02 / $422.67	Facility	26	$272.14	$318.02	$422.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $493.28 / $1,223.61 / $1,390.48	Professional		$493.28	$1,223.61	$1,390.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $121.68 / $364.22 / $413.89	Professional	26	$121.68	$364.22	$413.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $343.08 / $859.39 / $1,045.65	Professional	TC	$343.08	$859.39	$1,045.65
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $973.04 / $973.04 / $973.04	Facility	26	$973.04	$973.04	$973.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $492.23 / $1,291.16 / $6,025.38	Professional		$492.23	$1,291.16	$6,025.38
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $129.82 / $299.66 / $891.52	Professional	26	$129.82	$299.66	$891.52
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $351.60 / $922.27 / $5,457.89	Professional	TC	$351.60	$922.27	$5,457.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $80.83 / $207.99 / $615.87	Professional		$80.83	$207.99	$615.87
Quartz Facility/Professional Professional Modifier Low / Median / High Price $668.20 / $1,001.07 / $2,461.23	Professional		$668.20	$1,001.07	$2,461.23
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $247.43 / $973.04 / $973.04	Facility	26	$247.43	$973.04	$973.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $526.10 / $3,287.13 / $6,025.38	Professional		$526.10	$3,287.13	$6,025.38
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $153.41 / $540.90 / $891.52	Professional	26	$153.41	$540.90	$891.52
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $364.48 / $2,935.38 / $5,457.89	Professional	TC	$364.48	$2,935.38	$5,457.89
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,124.15 / $2,180.31 / $3,253.38	Professional		$2,124.15	$2,180.31	$3,253.38
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $455.18 / $607.27 / $809.78	Professional	26	$455.18	$607.27	$809.78
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,344.86 / $2,305.35 / $2,741.98	Professional	TC	$1,344.86	$2,305.35	$2,741.98
United Facility/Professional Professional Modifier Low / Median / High Price $431.65 / $1,022.33 / $2,250.14	Professional		$431.65	$1,022.33	$2,250.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $123.04 / $281.41 / $474.10	Professional	26	$123.04	$281.41	$474.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $324.55 / $730.24 / $2,230.01	Professional	TC	$324.55	$730.24	$2,230.01