Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $71.12 / $98.78 / $182.32	Facility	26	$71.12	$98.78	$182.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.46 / $263.01 / $884.00	Professional		$117.46	$263.01	$884.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.14 / $170.05 / $393.46	Professional	26	$44.14	$170.05	$393.46
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.16 / $101.84 / $248.44	Professional	TC	$63.16	$101.84	$248.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.56 / $177.57 / $652.57	Professional		$114.56	$177.57	$652.57
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.89 / $74.90 / $269.42	Professional	26	$45.89	$74.90	$269.42
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $68.68 / $106.45 / $385.94	Professional	TC	$68.68	$106.45	$385.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $50.24 / $80.84 / $145.22	Professional		$50.24	$80.84	$145.22
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $123.45 / $144.27 / $221.31	Facility	26	$123.45	$144.27	$221.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.38 / $414.05 / $470.51	Professional		$138.38	$414.05	$470.51
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.27 / $165.09 / $187.60	Professional	26	$57.27	$165.09	$187.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $82.94 / $248.96 / $282.91	Professional	TC	$82.94	$248.96	$282.91
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $211.96 / $211.96 / $494.00	Facility	26	$211.96	$211.96	$494.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $132.49 / $283.18 / $757.96	Professional		$132.49	$283.18	$757.96
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $53.47 / $112.65 / $312.14	Professional	26	$53.47	$112.65	$312.14
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $77.00 / $158.78 / $470.82	Professional	TC	$77.00	$158.78	$470.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.44 / $98.65 / $191.96	Professional		$41.44	$98.65	$191.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $94.73 / $275.29 / $500.67	Professional		$94.73	$275.29	$500.67
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $112.15 / $211.96 / $211.96	Facility	26	$112.15	$211.96	$211.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $174.39 / $593.10 / $757.96	Professional		$174.39	$593.10	$757.96
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $69.54 / $244.90 / $312.14	Professional	26	$69.54	$244.90	$312.14
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $104.85 / $348.20 / $470.82	Professional	TC	$104.85	$348.20	$470.82
Security Health Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $737.77 / $737.77	Professional		$257.04	$737.77	$737.77
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $144.94 / $270.20	Professional	26	$75.86	$144.94	$270.20
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $166.90 / $209.23 / $446.30	Professional	TC	$166.90	$209.23	$446.30
United Facility/Professional Professional Modifier Low / Median / High Price $130.56 / $228.69 / $494.68	Professional		$130.56	$228.69	$494.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.28 / $94.37 / $214.65	Professional	26	$51.28	$94.37	$214.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $75.09 / $138.60 / $305.20	Professional	TC	$75.09	$138.60	$305.20