Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $257.04 / $331.13 / $489.78	Facility	26	$257.04	$331.13	$489.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $562.34 / $2,570.40	Professional		$380.19	$562.34	$2,570.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $229.09 / $741.31	Professional	26	$120.23	$229.09	$741.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $346.74 / $630.96	Professional	TC	$251.19	$346.74	$630.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $616.60 / $2,137.96	Professional		$371.54	$616.60	$2,137.96
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $186.21 / $691.83	Professional	26	$120.23	$186.21	$691.83
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $426.58 / $1,479.11	Professional	TC	$251.19	$426.58	$1,479.11
CareSource Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $295.12 / $467.74	Professional		$154.88	$295.12	$467.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $323.59 / $371.54 / $602.56	Facility	26	$323.59	$371.54	$602.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $891.25 / $1,513.56	Professional		$389.05	$891.25	$1,513.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $251.19 / $501.19	Professional	26	$112.20	$251.19	$501.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $676.08 / $1,023.29	Professional	TC	$275.42	$676.08	$1,023.29
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $812.83 / $1,096.48	Professional		$676.08	$812.83	$1,096.48
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $223.87 / $269.15 / $363.08	Professional	26	$223.87	$269.15	$363.08
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $446.68 / $537.03 / $776.25	Professional	TC	$446.68	$537.03	$776.25
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $1,148.15 / $1,148.15 / $1,148.15	Facility	26	$1,148.15	$1,148.15	$1,148.15
Medica Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $933.25 / $3,890.45	Professional		$489.78	$933.25	$3,890.45
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $131.83 / $257.04 / $776.25	Professional	26	$131.83	$257.04	$776.25
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $660.69 / $3,311.31	Professional	TC	$338.84	$660.69	$3,311.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $575.44	Professional		$32.36	$33.11	$575.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $933.25 / $1,621.81	Professional		$478.63	$933.25	$1,621.81
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $281.84 / $1,122.02 / $1,122.02	Facility	26	$281.84	$1,122.02	$1,122.02
Quartz Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $2,041.74 / $4,073.80	Professional		$524.81	$2,041.74	$4,073.80
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $141.25 / $630.96 / $776.25	Professional	26	$141.25	$630.96	$776.25
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $363.08 / $1,479.11 / $3,388.44	Professional	TC	$363.08	$1,479.11	$3,388.44
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,137.96 / $2,344.23 / $3,162.28	Professional		$2,137.96	$2,344.23	$3,162.28
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $575.44 / $741.31 / $954.99	Professional	26	$575.44	$741.31	$954.99
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,318.26 / $1,737.80 / $2,137.96	Professional	TC	$1,318.26	$1,737.80	$2,137.96
United Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $741.31 / $1,584.89	Professional		$426.58	$741.31	$1,584.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $213.80 / $467.74	Professional	26	$128.82	$213.80	$467.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $537.03 / $1,148.15	Professional	TC	$295.12	$537.03	$1,148.15