Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.45 / $381.60 / $980.46	Facility		$75.45	$381.60	$980.46
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.41 / $27.88 / $27.88	Facility	26	$20.41	$27.88	$27.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.91 / $40.79 / $78.48	Professional		$30.91	$40.79	$78.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.56 / $20.41 / $143.25	Professional	26	$12.56	$20.41	$143.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.89 / $27.03 / $46.85	Professional	TC	$17.89	$27.03	$46.85
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.14 / $69.75 / $220.20	Professional		$33.14	$69.75	$220.20
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.17 / $26.93 / $84.38	Professional	26	$13.17	$26.93	$84.38
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.97 / $41.42 / $141.87	Professional	TC	$18.97	$41.42	$141.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $14.00 / $29.81 / $50.79	Facility		$14.00	$29.81	$50.79
CareSource Facility/Professional Professional Modifier Low / Median / High Price $14.88 / $29.89 / $69.75	Professional		$14.88	$29.89	$69.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $102.73 / $120.05 / $184.15	Facility		$102.73	$120.05	$184.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.14 / $41.07 / $63.00	Facility	26	$35.14	$41.07	$63.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.18 / $124.88 / $151.51	Professional		$44.18	$124.88	$151.51
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.21 / $47.37 / $53.83	Professional	26	$19.21	$47.37	$53.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.07 / $83.09 / $97.74	Professional	TC	$25.07	$83.09	$97.74
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $32.72 / $47.63 / $76.13	Facility		$32.72	$47.63	$76.13
Medica Facility/Professional Facility Modifier Low / Median / High Price $32.72 / $47.63 / $164.71	Facility		$32.72	$47.63	$164.71
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $37.81 / $80.67 / $287.00	Professional		$37.81	$80.67	$287.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $15.75 / $34.02 / $204.67	Professional	26	$15.75	$34.02	$204.67
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $22.37 / $46.38 / $230.00	Professional	TC	$22.37	$46.38	$230.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.72 / $55.02 / $77.04	Professional		$20.72	$55.02	$77.04
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $32.72 / $47.63 / $76.13	Facility		$32.72	$47.63	$76.13
Quartz Facility/Professional Professional Modifier Low / Median / High Price $37.84 / $90.71 / $135.58	Professional		$37.84	$90.71	$135.58
Quartz Facility/Professional Facility Modifier Low / Median / High Price $90.58 / $514.16 / $514.16	Facility		$90.58	$514.16	$514.16
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $32.18 / $100.00 / $100.00	Facility	26	$32.18	$100.00	$100.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $56.16 / $176.90 / $287.00	Professional		$56.16	$176.90	$287.00
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $19.94 / $70.70 / $204.67	Professional	26	$19.94	$70.70	$204.67
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $36.22 / $106.15 / $230.00	Professional	TC	$36.22	$106.15	$230.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $80.69 / $237.59 / $237.59	Professional		$80.69	$237.59	$237.59
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $24.28 / $41.49 / $80.70	Professional	26	$24.28	$41.49	$80.70
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $24.28 / $48.17 / $119.43	Professional	TC	$24.28	$48.17	$119.43
United Facility/Professional Professional Modifier Low / Median / High Price $37.17 / $67.94 / $155.05	Professional		$37.17	$67.94	$155.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $32.29 / $61.97	Professional	26	$15.49	$32.29	$61.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.37 / $41.42 / $92.84	Professional	TC	$22.37	$41.42	$92.84