Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.16 / $127.45 / $484.72	Facility		$72.16	$127.45	$484.72
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.05 / $52.95 / $63.99	Facility	26	$46.05	$52.95	$63.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.20 / $82.40 / $192.52	Professional		$45.20	$82.40	$192.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.25 / $48.07 / $185.65	Professional	26	$27.25	$48.07	$185.65
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $94.51 / $94.51 / $205.00	Professional	50	$94.51	$94.51	$205.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.05 / $32.97 / $69.48	Professional	TC	$15.05	$32.97	$69.48
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.55 / $96.32 / $294.77	Professional		$46.55	$96.32	$294.77
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.71 / $55.85 / $189.05	Professional	26	$29.71	$55.85	$189.05
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $69.81 / $152.62 / $442.15	Professional	50	$69.81	$152.62	$442.15
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.85 / $39.43 / $111.64	Professional	TC	$16.85	$39.43	$111.64
CareSource Facility/Professional Facility Modifier Low / Median / High Price $17.23 / $38.03 / $61.36	Facility		$17.23	$38.03	$61.36
CareSource Facility/Professional Professional Modifier Low / Median / High Price $18.02 / $36.10 / $60.38	Professional		$18.02	$36.10	$60.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $129.76 / $151.63 / $232.61	Facility		$129.76	$151.63	$232.61
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.09 / $94.77 / $145.38	Facility	26	$81.09	$94.77	$145.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.56 / $170.25 / $193.46	Professional		$72.56	$170.25	$193.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.08 / $107.68 / $122.36	Professional	26	$44.08	$107.68	$122.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.90 / $62.52 / $74.48	Professional	TC	$26.90	$62.52	$74.48
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $42.30 / $90.19 / $180.40	Facility		$42.30	$90.19	$180.40
Medica Facility/Professional Facility Modifier Low / Median / High Price $42.30 / $93.81 / $271.91	Facility		$42.30	$93.81	$271.91
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $198.78 / $198.78 / $198.78	Facility	26	$198.78	$198.78	$198.78
Medica Facility/Professional Professional Modifier Low / Median / High Price $61.93 / $144.51 / $659.45	Professional		$61.93	$144.51	$659.45
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $37.54 / $82.66 / $335.18	Professional	26	$37.54	$82.66	$335.18
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $24.38 / $63.43 / $404.98	Professional	TC	$24.38	$63.43	$404.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.84 / $60.55 / $127.76	Professional		$25.84	$60.55	$127.76
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $43.72 / $90.19 / $174.72	Facility		$43.72	$90.19	$174.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $89.25 / $136.13 / $262.25	Professional		$89.25	$136.13	$262.25
Quartz Facility/Professional Facility Modifier Low / Median / High Price $156.80 / $338.68 / $338.68	Facility		$156.80	$338.68	$338.68
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $198.78 / $198.78	Facility	26	$100.00	$198.78	$198.78
Quartz Facility/Professional Professional Modifier Low / Median / High Price $71.70 / $374.43 / $659.45	Professional		$71.70	$374.43	$659.45
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $45.36 / $164.49 / $335.18	Professional	26	$45.36	$164.49	$335.18
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $26.34 / $217.86 / $404.98	Professional	TC	$26.34	$217.86	$404.98
Security Health Facility/Professional Professional Modifier Low / Median / High Price $251.86 / $303.32 / $336.87	Professional		$251.86	$303.32	$336.87
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $131.21 / $154.36 / $300.95	Professional	26	$131.21	$154.36	$300.95
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $83.22 / $111.88 / $232.13	Professional	TC	$83.22	$111.88	$232.13
United Facility/Professional Facility Modifier Low / Median / High Price $187.89 / $187.89 / $187.89	Facility		$187.89	$187.89	$187.89
United Facility/Professional Professional Modifier Low / Median / High Price $57.52 / $129.03 / $273.45	Professional		$57.52	$129.03	$273.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.96 / $79.16 / $175.63	Professional	26	$35.96	$79.16	$175.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.65 / $52.46 / $155.16	Professional	TC	$21.65	$52.46	$155.16