Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $219.73 / $236.77 / $236.77	Facility	26	$219.73	$236.77	$236.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $280.95 / $444.03 / $1,876.56	Professional		$280.95	$444.03	$1,876.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $111.36 / $219.73 / $1,297.70	Professional	26	$111.36	$219.73	$1,297.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $170.16 / $288.69 / $478.73	Professional	TC	$170.16	$288.69	$478.73
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $320.51 / $827.14 / $2,541.42	Professional		$320.51	$827.14	$2,541.42
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $109.86 / $261.22 / $860.21	Professional	26	$109.86	$261.22	$860.21
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $210.64 / $586.82 / $1,681.23	Professional	TC	$210.64	$586.82	$1,681.23
CareSource Facility/Professional Professional Modifier Low / Median / High Price $125.83 / $257.58 / $445.89	Professional		$125.83	$257.58	$445.89
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $295.57 / $345.39 / $459.06	Facility	26	$295.57	$345.39	$459.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $472.29 / $1,161.79 / $1,320.21	Professional		$472.29	$1,161.79	$1,320.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $125.65 / $395.77 / $449.74	Professional	26	$125.65	$395.77	$449.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $309.18 / $765.99 / $870.44	Professional	TC	$309.18	$765.99	$870.44
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $1,056.00 / $1,056.00 / $1,056.00	Facility	26	$1,056.00	$1,056.00	$1,056.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $418.37 / $944.82 / $2,091.94	Professional		$418.37	$944.82	$2,091.94
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $133.56 / $309.38 / $711.82	Professional	26	$133.56	$309.38	$711.82
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $277.82 / $640.76 / $1,773.11	Professional	TC	$277.82	$640.76	$1,773.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $80.83 / $191.29 / $542.83	Professional		$80.83	$191.29	$542.83
Quartz Facility/Professional Professional Modifier Low / Median / High Price $639.60 / $880.27 / $1,404.82	Professional		$639.60	$880.27	$1,404.82
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $268.85 / $1,056.00 / $1,056.00	Facility	26	$268.85	$1,056.00	$1,056.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $489.31 / $1,448.10 / $2,091.94	Professional		$489.31	$1,448.10	$2,091.94
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $166.69 / $585.60 / $711.82	Professional	26	$166.69	$585.60	$711.82
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $322.62 / $862.55 / $1,773.11	Professional	TC	$322.62	$862.55	$1,773.11
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,159.25 / $1,816.66 / $1,825.43	Professional		$1,159.25	$1,816.66	$1,825.43
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $273.11 / $392.12 / $641.65	Professional	26	$273.11	$392.12	$641.65
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $770.12 / $971.70 / $1,926.63	Professional	TC	$770.12	$971.70	$1,926.63
United Facility/Professional Professional Modifier Low / Median / High Price $388.18 / $847.72 / $1,956.95	Professional		$388.18	$847.72	$1,956.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $120.90 / $245.15 / $513.28	Professional	26	$120.90	$245.15	$513.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $255.49 / $603.35 / $1,299.54	Professional	TC	$255.49	$603.35	$1,299.54