Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $239.25 / $636.02 / $989.82	Facility		$239.25	$636.02	$989.82
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.13 / $58.30 / $210.49	Facility	26	$42.13	$58.30	$210.49
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $122.83 / $484.79 / $870.17	Facility	TC	$122.83	$484.79	$870.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.23 / $153.52 / $695.00	Professional		$85.23	$153.52	$695.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.39 / $69.45 / $267.75	Professional	26	$26.39	$69.45	$267.75
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.32 / $89.98 / $409.05	Professional	TC	$54.32	$89.98	$409.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.23 / $132.11 / $485.22	Professional		$85.23	$132.11	$485.22
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.18 / $44.28 / $158.60	Professional	26	$27.18	$44.28	$158.60
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $58.05 / $89.98 / $326.62	Professional	TC	$58.05	$89.98	$326.62
CareSource Facility/Professional Facility Modifier Low / Median / High Price $28.91 / $69.30 / $109.86	Facility		$28.91	$69.30	$109.86
CareSource Facility/Professional Professional Modifier Low / Median / High Price $29.69 / $65.81 / $107.37	Professional		$29.69	$65.81	$107.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $236.99 / $276.95 / $424.84	Facility		$236.99	$276.95	$424.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.98 / $85.30 / $130.85	Facility	26	$72.98	$85.30	$130.85
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $164.00 / $191.65 / $294.00	Facility	TC	$164.00	$191.65	$294.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.29 / $306.04 / $347.78	Professional		$109.29	$306.04	$347.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.94 / $96.93 / $110.15	Professional	26	$33.94	$96.93	$110.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $71.92 / $209.07 / $237.58	Professional	TC	$71.92	$209.07	$237.58
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $76.93 / $132.11 / $256.56	Facility		$76.93	$132.11	$256.56
Medica Facility/Professional Facility Modifier Low / Median / High Price $80.50 / $187.89 / $633.11	Facility		$80.50	$187.89	$633.11
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $125.66 / $125.66 / $531.00	Facility	26	$125.66	$125.66	$531.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $267.93 / $522.44 / $711.44	Facility	TC	$267.93	$522.44	$711.44
Medica Facility/Professional Professional Modifier Low / Median / High Price $98.22 / $201.10 / $568.24	Professional		$98.22	$201.10	$568.24
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $32.22 / $74.25 / $227.85	Professional	26	$32.22	$74.25	$227.85
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $65.94 / $135.36 / $390.02	Professional	TC	$65.94	$135.36	$390.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.69 / $94.25 / $191.96	Professional		$38.69	$94.25	$191.96
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $76.93 / $130.80 / $233.93	Facility		$76.93	$130.80	$233.93
Quartz Facility/Professional Professional Modifier Low / Median / High Price $162.27 / $247.52 / $390.00	Professional		$162.27	$247.52	$390.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $218.16 / $514.16 / $514.16	Facility		$218.16	$514.16	$514.16
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $125.66 / $125.66	Facility	26	$100.00	$125.66	$125.66
Quartz Facility/Professional Facility Modifier TC Low / Median / High Price $142.03 / $267.93 / $267.93	Facility	TC	$142.03	$267.93	$267.93
Quartz Facility/Professional Professional Modifier Low / Median / High Price $128.88 / $441.00 / $568.24	Professional		$128.88	$441.00	$568.24
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $40.83 / $144.15 / $227.85	Professional	26	$40.83	$144.15	$227.85
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $88.06 / $296.85 / $390.02	Professional	TC	$88.06	$296.85	$390.02
Security Health Facility/Professional Professional Modifier Low / Median / High Price $235.46 / $545.30 / $545.30	Professional		$235.46	$545.30	$545.30
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $85.46 / $106.21 / $158.11	Professional	26	$85.46	$106.21	$158.11
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $127.45 / $176.11 / $451.94	Professional	TC	$127.45	$176.11	$451.94
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 $93.95 / $163.47 / $361.62	Professional		$93.95	$163.47	$361.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.77 / $87.90 / $175.79	Professional	26	$33.77	$87.90	$175.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $62.80 / $121.71 / $260.19	Professional	TC	$62.80	$121.71	$260.19