Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $157.38 / $211.86 / $729.52	Facility		$157.38	$211.86	$729.52
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.49 / $27.01 / $32.63	Facility	26	$23.49	$27.01	$32.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.59 / $111.33 / $222.02	Professional		$81.59	$111.33	$222.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.98 / $23.49 / $86.00	Professional	26	$13.98	$23.49	$86.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $68.22 / $95.43 / $180.28	Professional	TC	$68.22	$95.43	$180.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $90.96 / $205.60 / $577.57	Professional		$90.96	$205.60	$577.57
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.15 / $34.28 / $95.48	Professional	26	$15.15	$34.28	$95.48
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $72.95 / $174.83 / $493.57	Professional	TC	$72.95	$174.83	$493.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $285.66 / $333.81 / $443.66	Facility		$285.66	$333.81	$443.66
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.54 / $47.39 / $62.98	Facility	26	$40.54	$47.39	$62.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.71 / $365.99 / $415.90	Professional		$95.71	$365.99	$415.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.22 / $54.91 / $62.40	Professional	26	$18.22	$54.91	$62.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $78.43 / $311.08 / $353.50	Professional	TC	$78.43	$311.08	$353.50
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $80.56 / $118.40 / $220.10	Facility		$80.56	$118.40	$220.10
Medica Facility/Professional Facility Modifier Low / Median / High Price $80.56 / $126.29 / $285.77	Facility		$80.56	$126.29	$285.77
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $99.50 / $226.54 / $687.89	Professional		$99.50	$226.54	$687.89
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $18.39 / $42.48 / $150.00	Professional	26	$18.39	$42.48	$150.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $82.29 / $187.64 / $591.79	Professional	TC	$82.29	$187.64	$591.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $57.01 / $92.86 / $216.49	Professional		$57.01	$92.86	$216.49
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $80.56 / $118.40 / $220.10	Facility		$80.56	$118.40	$220.10
Quartz Facility/Professional Professional Modifier Low / Median / High Price $197.60 / $243.48 / $353.96	Professional		$197.60	$243.48	$353.96
Quartz Facility/Professional Facility Modifier Low / Median / High Price $248.63 / $460.18 / $460.18	Facility		$248.63	$460.18	$460.18
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $154.13 / $470.00 / $687.89	Professional		$154.13	$470.00	$687.89
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $25.43 / $80.70 / $150.00	Professional	26	$25.43	$80.70	$150.00
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $131.02 / $389.30 / $591.79	Professional	TC	$131.02	$389.30	$591.79
Security Health Facility/Professional Professional Modifier Low / Median / High Price $176.13 / $604.62 / $652.11	Professional		$176.13	$604.62	$652.11
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $36.21 / $45.82 / $88.19	Professional	26	$36.21	$45.82	$88.19
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $118.94 / $139.93 / $411.11	Professional	TC	$118.94	$139.93	$411.11
United Facility/Professional Facility Modifier Low / Median / High Price $111.86 / $188.06 / $191.54	Facility		$111.86	$188.06	$191.54
United Facility/Professional Professional Modifier Low / Median / High Price $98.89 / $201.72 / $380.70	Professional		$98.89	$201.72	$380.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.29 / $37.18 / $70.73	Professional	26	$17.29	$37.18	$70.73
United Facility/Professional Professional Modifier TC Low / Median / High Price $82.12 / $157.82 / $300.51	Professional	TC	$82.12	$157.82	$300.51