Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $240.80 / $829.69 / $1,439.96	Facility		$240.80	$829.69	$1,439.96
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.95 / $66.33 / $80.12	Facility	26	$40.95	$66.33	$80.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $111.38 / $203.66 / $933.04	Professional		$111.38	$203.66	$933.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.96 / $68.17 / $320.54	Professional	26	$35.96	$68.17	$320.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $71.05 / $117.93 / $292.92	Professional	TC	$71.05	$117.93	$292.92
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $113.29 / $175.60 / $654.53	Professional		$113.29	$175.60	$654.53
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.21 / $66.20 / $220.50	Professional	26	$37.21	$66.20	$220.50
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $76.08 / $117.93 / $434.03	Professional	TC	$76.08	$117.93	$434.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $39.69 / $90.99 / $146.34	Facility		$39.69	$90.99	$146.34
CareSource Facility/Professional Professional Modifier Low / Median / High Price $40.79 / $86.14 / $143.04	Professional		$40.79	$86.14	$143.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $317.19 / $370.67 / $568.61	Facility		$317.19	$370.67	$568.61
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.02 / $116.89 / $179.31	Facility	26	$100.02	$116.89	$179.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $146.13 / $408.83 / $464.58	Professional		$146.13	$408.83	$464.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.75 / $133.66 / $151.88	Professional	26	$46.75	$133.66	$151.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $98.41 / $275.13 / $312.64	Professional	TC	$98.41	$275.13	$312.64
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $102.27 / $175.50 / $322.14	Facility		$102.27	$175.50	$322.14
Medica Facility/Professional Facility Modifier Low / Median / High Price $102.27 / $225.30 / $662.00	Facility		$102.27	$225.30	$662.00
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $172.60 / $172.60 / $615.00	Facility	26	$172.60	$172.60	$615.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $132.55 / $271.27 / $760.68	Professional		$132.55	$271.27	$760.68
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $43.81 / $100.10 / $303.79	Professional	26	$43.81	$100.10	$303.79
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $86.76 / $174.66 / $518.02	Professional	TC	$86.76	$174.66	$518.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.36 / $112.06 / $253.98	Professional		$41.36	$112.06	$253.98
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $102.27 / $170.00 / $308.52	Facility		$102.27	$170.00	$308.52
Quartz Facility/Professional Professional Modifier Low / Median / High Price $215.94 / $329.39 / $519.00	Professional		$215.94	$329.39	$519.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $277.73 / $523.79 / $523.79	Facility		$277.73	$523.79	$523.79
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $172.60 / $172.60	Facility	26	$100.00	$172.60	$172.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $172.18 / $594.90 / $760.68	Professional		$172.18	$594.90	$760.68
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $56.30 / $200.45 / $303.79	Professional	26	$56.30	$200.45	$303.79
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $115.88 / $394.45 / $518.02	Professional	TC	$115.88	$394.45	$518.02
Security Health Facility/Professional Professional Modifier Low / Median / High Price $313.02 / $728.44 / $728.44	Professional		$313.02	$728.44	$728.44
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $117.06 / $145.66 / $219.14	Professional	26	$117.06	$145.66	$219.14
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $166.90 / $233.32 / $574.03	Professional	TC	$166.90	$233.32	$574.03
United Facility/Professional Professional Modifier Low / Median / High Price $126.79 / $224.75 / $521.27	Professional		$126.79	$224.75	$521.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.86 / $76.73 / $154.35	Professional	26	$41.86	$76.73	$154.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $86.23 / $150.21 / $345.74	Professional	TC	$86.23	$150.21	$345.74