Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.34 / $94.70 / $94.70	Facility	26	$68.34	$94.70	$94.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.90 / $144.85 / $311.13	Professional		$85.90	$144.85	$311.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.39 / $46.12 / $270.81	Professional	26	$17.39	$46.12	$270.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $44.52 / $76.51 / $212.38	Professional	TC	$44.52	$76.51	$212.38
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $92.99 / $201.42 / $570.54	Professional		$92.99	$201.42	$570.54
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.25 / $68.34 / $245.92	Professional	26	$17.25	$68.34	$245.92
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $49.36 / $143.61 / $319.58	Professional	TC	$49.36	$143.61	$319.58
CareSource Facility/Professional Professional Modifier Low / Median / High Price $48.44 / $60.18 / $147.41	Professional		$48.44	$60.18	$147.41
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.05 / $137.94 / $183.34	Facility	26	$118.05	$137.94	$183.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $133.13 / $337.22 / $526.87	Professional		$133.13	$337.22	$526.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.39 / $158.62 / $180.25	Professional	26	$23.39	$158.62	$180.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $72.14 / $178.60 / $279.05	Professional	TC	$72.14	$178.60	$279.05
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $205.87 / $205.87 / $205.87	Facility	26	$205.87	$205.87	$205.87
Medica Facility/Professional Professional Modifier Low / Median / High Price $118.28 / $287.01 / $2,899.89	Professional		$118.28	$287.01	$2,899.89
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $30.95 / $76.45 / $425.60	Professional	26	$30.95	$76.45	$425.60
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $67.94 / $189.22 / $2,808.09	Professional	TC	$67.94	$189.22	$2,808.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.69 / $91.34 / $207.38	Professional		$38.69	$91.34	$207.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $186.55 / $279.48 / $518.55	Professional		$186.55	$279.48	$518.55
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $107.75 / $205.87 / $205.87	Facility	26	$107.75	$205.87	$205.87
Quartz Facility/Professional Professional Modifier Low / Median / High Price $156.24 / $1,564.70 / $2,899.89	Professional		$156.24	$1,564.70	$2,899.89
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $66.81 / $235.45 / $425.60	Professional	26	$66.81	$235.45	$425.60
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $84.93 / $1,507.97 / $2,808.09	Professional	TC	$84.93	$1,507.97	$2,808.09
Security Health Facility/Professional Professional Modifier Low / Median / High Price $167.18 / $592.33 / $600.91	Professional		$167.18	$592.33	$600.91
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $38.20 / $69.79 / $213.99	Professional	26	$38.20	$69.79	$213.99
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $125.42 / $147.55 / $470.72	Professional	TC	$125.42	$147.55	$470.72
United Facility/Professional Professional Modifier Low / Median / High Price $115.44 / $253.92 / $757.73	Professional		$115.44	$253.92	$757.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.15 / $58.80 / $175.41	Professional	26	$33.15	$58.80	$175.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $61.12 / $132.96 / $425.47	Professional	TC	$61.12	$132.96	$425.47