Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.55 / $68.11 / $68.11	Facility	26	$48.55	$68.11	$68.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $119.30 / $235.60 / $751.59	Professional		$119.30	$235.60	$751.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.27 / $48.55 / $190.46	Professional	26	$30.27	$48.55	$190.46
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $90.19 / $137.15 / $973.90	Professional	TC	$90.19	$137.15	$973.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.26 / $287.04 / $1,095.14	Professional		$125.26	$287.04	$1,095.14
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.32 / $49.41 / $183.46	Professional	26	$31.32	$49.41	$183.46
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $91.87 / $210.51 / $920.14	Professional	TC	$91.87	$210.51	$920.14
CareSource Facility/Professional Professional Modifier Low / Median / High Price $34.60 / $176.84 / $239.53	Professional		$34.60	$176.84	$239.53
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.51 / $101.09 / $155.08	Facility	26	$86.51	$101.09	$155.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $155.63 / $708.69 / $805.33	Professional		$155.63	$708.69	$805.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.86 / $114.64 / $130.28	Professional	26	$39.86	$114.64	$130.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $121.76 / $594.01 / $675.01	Professional	TC	$121.76	$594.01	$675.01
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $147.81 / $147.81 / $147.81	Facility	26	$147.81	$147.81	$147.81
Medica Facility/Professional Professional Modifier Low / Median / High Price $137.94 / $310.64 / $898.89	Professional		$137.94	$310.64	$898.89
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $36.36 / $76.04 / $371.50	Professional	26	$36.36	$76.04	$371.50
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $92.78 / $224.70 / $695.99	Professional	TC	$92.78	$224.70	$695.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $56.22 / $150.34 / $315.99	Professional		$56.22	$150.34	$315.99
Quartz Facility/Professional Professional Modifier Low / Median / High Price $298.68 / $464.60 / $668.87	Professional		$298.68	$464.60	$668.87
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $147.81 / $147.81	Facility	26	$100.00	$147.81	$147.81
Quartz Facility/Professional Professional Modifier Low / Median / High Price $243.86 / $698.20 / $898.89	Professional		$243.86	$698.20	$898.89
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $48.29 / $170.00 / $371.50	Professional	26	$48.29	$170.00	$371.50
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $192.12 / $531.45 / $695.99	Professional	TC	$192.12	$531.45	$695.99
Security Health Facility/Professional Professional Modifier Low / Median / High Price $272.58 / $871.43 / $871.43	Professional		$272.58	$871.43	$871.43
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $97.48 / $123.34 / $206.35	Professional	26	$97.48	$123.34	$206.35
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $175.11 / $212.42 / $597.22	Professional	TC	$175.11	$212.42	$597.22
United Facility/Professional Professional Modifier Low / Median / High Price $140.19 / $241.27 / $580.74	Professional		$140.19	$241.27	$580.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.22 / $65.15 / $136.74	Professional	26	$36.22	$65.15	$136.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $102.97 / $202.92 / $443.14	Professional	TC	$102.97	$202.92	$443.14