Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $71.62 / $99.47 / $100.26	Facility	26	$71.62	$99.47	$100.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $130.55 / $280.18 / $846.45	Professional		$130.55	$280.18	$846.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.14 / $167.81 / $460.31	Professional	26	$44.14	$167.81	$460.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $78.95 / $132.56 / $529.70	Professional	TC	$78.95	$132.56	$529.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.72 / $245.56 / $746.79	Professional		$131.72	$245.56	$746.79
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $46.21 / $75.95 / $269.42	Professional	26	$46.21	$75.95	$269.42
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $85.52 / $132.56 / $482.89	Professional	TC	$85.52	$132.56	$482.89
CareSource Facility/Professional Professional Modifier Low / Median / High Price $50.58 / $100.83 / $166.45	Professional		$50.58	$100.83	$166.45
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $124.35 / $145.32 / $222.92	Facility	26	$124.35	$145.32	$222.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $163.16 / $477.76 / $542.91	Professional		$163.16	$477.76	$542.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.85 / $166.27 / $188.94	Professional	26	$56.85	$166.27	$188.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $106.08 / $311.49 / $353.96	Professional	TC	$106.08	$311.49	$353.96
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $213.45 / $213.45 / $440.00	Facility	26	$213.45	$213.45	$440.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $151.50 / $312.22 / $872.98	Professional		$151.50	$312.22	$872.98
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $53.47 / $112.65 / $298.50	Professional	26	$53.47	$112.65	$298.50
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $95.40 / $197.84 / $574.48	Professional	TC	$95.40	$197.84	$574.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $57.31 / $135.30 / $253.98	Professional		$57.31	$135.30	$253.98
Quartz Facility/Professional Professional Modifier Low / Median / High Price $250.89 / $318.38 / $591.76	Professional		$250.89	$318.38	$591.76
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $112.95 / $213.45 / $213.45	Facility	26	$112.95	$213.45	$213.45
Quartz Facility/Professional Professional Modifier Low / Median / High Price $201.22 / $678.75 / $872.98	Professional		$201.22	$678.75	$872.98
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $70.03 / $244.90 / $298.50	Professional	26	$70.03	$244.90	$298.50
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $131.19 / $433.85 / $574.48	Professional	TC	$131.19	$433.85	$574.48
Security Health Facility/Professional Professional Modifier Low / Median / High Price $364.46 / $851.30 / $851.30	Professional		$364.46	$851.30	$851.30
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $145.43 / $166.90 / $272.08	Professional	26	$145.43	$166.90	$272.08
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $182.07 / $262.42 / $564.66	Professional	TC	$182.07	$262.42	$564.66
United Facility/Professional Professional Modifier Low / Median / High Price $145.08 / $236.72 / $549.79	Professional		$145.08	$236.72	$549.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.47 / $106.51 / $186.85	Professional	26	$51.47	$106.51	$186.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $94.75 / $165.31 / $334.06	Professional	TC	$94.75	$165.31	$334.06