Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $217.36 / $234.23 / $234.23	Facility	26	$217.36	$234.23	$234.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $284.20 / $496.27 / $1,641.35	Professional		$284.20	$496.27	$1,641.35
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $108.68 / $217.36 / $1,266.50	Professional	26	$108.68	$217.36	$1,266.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $168.65 / $341.67 / $449.16	Professional	TC	$168.65	$341.67	$449.16
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $410.43 / $962.99 / $3,192.50	Professional		$410.43	$962.99	$3,192.50
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $108.68 / $258.41 / $853.46	Professional	26	$108.68	$258.41	$853.46
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $301.75 / $710.91 / $2,176.56	Professional	TC	$301.75	$710.91	$2,176.56
CareSource Facility/Professional Professional Modifier Low / Median / High Price $124.60 / $363.41 / $565.11	Professional		$124.60	$363.41	$565.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $292.86 / $342.23 / $454.86	Facility	26	$292.86	$342.23	$454.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $564.55 / $1,480.71 / $1,682.63	Professional		$564.55	$1,480.71	$1,682.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $129.65 / $391.90 / $445.34	Professional	26	$129.65	$391.90	$445.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $383.15 / $1,088.81 / $1,237.29	Professional	TC	$383.15	$1,088.81	$1,237.29
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $835.05 / $1,048.24 / $1,048.24	Facility	26	$835.05	$1,048.24	$1,048.24
Medica Facility/Professional Professional Modifier Low / Median / High Price $497.34 / $1,162.65 / $4,801.00	Professional		$497.34	$1,162.65	$4,801.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $136.06 / $308.17 / $1,632.94	Professional	26	$136.06	$308.17	$1,632.94
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $358.39 / $861.80 / $3,601.00	Professional	TC	$358.39	$861.80	$3,601.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $80.83 / $188.32 / $487.55	Professional		$80.83	$188.32	$487.55
Quartz Facility/Professional Professional Modifier Low / Median / High Price $813.15 / $986.79 / $1,790.46	Professional		$813.15	$986.79	$1,790.46
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $266.23 / $1,048.24 / $1,048.24	Facility	26	$266.23	$1,048.24	$1,048.24
Quartz Facility/Professional Professional Modifier Low / Median / High Price $623.64 / $2,229.61 / $4,801.00	Professional		$623.64	$2,229.61	$4,801.00
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $165.06 / $583.29 / $1,632.94	Professional	26	$165.06	$583.29	$1,632.94
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $458.58 / $1,855.18 / $3,601.00	Professional	TC	$458.58	$1,855.18	$3,601.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,050.30 / $1,811.79 / $2,033.00	Professional		$1,050.30	$1,811.79	$2,033.00
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $273.11 / $393.22 / $644.04	Professional	26	$273.11	$393.22	$644.04
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $758.63 / $842.44 / $1,878.04	Professional	TC	$758.63	$842.44	$1,878.04
United Facility/Professional Professional Modifier Low / Median / High Price $476.62 / $1,043.16 / $1,880.18	Professional		$476.62	$1,043.16	$1,880.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $127.51 / $283.66 / $580.66	Professional	26	$127.51	$283.66	$580.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $358.39 / $780.90 / $1,753.31	Professional	TC	$358.39	$780.90	$1,753.31