Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.49 / $63.92 / $63.92	Facility	26	$45.49	$63.92	$63.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.49 / $95.89 / $171.00	Professional		$63.49	$95.89	$171.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.28 / $37.54 / $80.42	Professional	26	$26.28	$37.54	$80.42
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $28.66 / $38.28 / $90.49	Professional	52	$28.66	$38.28	$90.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $31.80 / $53.64 / $72.43	Professional	TC	$31.80	$53.64	$72.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.89 / $101.05 / $386.13	Professional		$64.89	$101.05	$386.13
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.35 / $46.33 / $170.01	Professional	26	$29.35	$46.33	$170.01
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $97.33 / $158.35 / $579.20	Professional	50	$97.33	$158.35	$579.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $33.58 / $59.33 / $225.22	Professional	TC	$33.58	$59.33	$225.22
CareSource Facility/Professional Professional Modifier Low / Median / High Price $64.13 / $74.05 / $138.18	Professional		$64.13	$74.05	$138.18
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $80.20 / $93.72 / $143.77	Facility	26	$80.20	$93.72	$143.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $98.42 / $240.46 / $273.25	Professional		$98.42	$240.46	$273.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.99 / $106.43 / $120.94	Professional	26	$32.99	$106.43	$120.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $54.38 / $134.07 / $152.35	Professional	TC	$54.38	$134.07	$152.35
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $136.22 / $136.22 / $136.22	Facility	26	$136.22	$136.22	$136.22
Medica Facility/Professional Professional Modifier Low / Median / High Price $75.59 / $152.66 / $497.00	Professional		$75.59	$152.66	$497.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $31.96 / $69.77 / $320.31	Professional	26	$31.96	$69.77	$320.31
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $39.25 / $89.87 / $320.31	Professional	TC	$39.25	$89.87	$320.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.84 / $61.13 / $127.76	Professional		$25.84	$61.13	$127.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $127.32 / $194.21 / $306.00	Professional		$127.32	$194.21	$306.00
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $136.22 / $136.22	Facility	26	$100.00	$136.22	$136.22
Quartz Facility/Professional Professional Modifier Low / Median / High Price $101.28 / $324.64 / $497.00	Professional		$101.28	$324.64	$497.00
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $44.82 / $154.55 / $320.31	Professional	26	$44.82	$154.55	$320.31
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $56.46 / $170.10 / $320.31	Professional	TC	$56.46	$170.10	$320.31
Security Health Facility/Professional Professional Modifier Low / Median / High Price $206.35 / $428.52 / $428.52	Professional		$206.35	$428.52	$428.52
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $91.29 / $97.10 / $176.52	Professional	26	$91.29	$97.10	$176.52
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $109.24 / $150.02 / $309.17	Professional	TC	$109.24	$150.02	$309.17
United Facility/Professional Professional Modifier Low / Median / High Price $72.45 / $135.69 / $284.56	Professional		$72.45	$135.69	$284.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.76 / $60.27 / $125.19	Professional	26	$31.76	$60.27	$125.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.07 / $77.56 / $149.09	Professional	TC	$39.07	$77.56	$149.09