Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $831.76 / $1,288.25	Facility		$234.42	$831.76	$1,288.25
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.67 / $52.48 / $87.10	Facility	26	$44.67	$52.48	$87.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $112.20 / $707.95	Professional		$50.12	$112.20	$707.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $51.29 / $208.93	Professional	26	$26.92	$51.29	$208.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $38.02 / $186.21	Professional	TC	$20.89	$38.02	$186.21
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $87.10 / $316.23	Professional		$56.23	$87.10	$316.23
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $45.71 / $154.88	Professional	26	$29.51	$45.71	$154.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $41.69 / $144.54	Professional	TC	$26.92	$41.69	$144.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $46.77 / $95.50	Facility		$34.67	$46.77	$95.50
CareSource Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $46.77 / $102.33	Professional		$28.18	$46.77	$102.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $181.97 / $288.40	Facility		$154.88	$181.97	$288.40
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.62 / $91.20 / $144.54	Facility	26	$77.62	$91.20	$144.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $177.83 / $234.42	Professional		$67.61	$177.83	$234.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $69.18 / $123.03	Professional	26	$33.88	$69.18	$123.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $100.00 / $138.04	Professional	TC	$33.11	$100.00	$138.04
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $109.65 / $218.78	Facility		$51.29	$109.65	$218.78
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $123.03 / $165.96	Professional		$107.15	$123.03	$165.96
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $63.10 / $85.11	Professional	26	$54.95	$63.10	$85.11
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $60.26 / $81.28	Professional	TC	$52.48	$60.26	$81.28
Medica Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $141.25 / $794.33	Facility		$54.95	$141.25	$794.33
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $263.03 / $263.03 / $363.08	Facility	26	$263.03	$263.03	$363.08
Medica Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $186.21 / $954.99	Professional		$63.10	$186.21	$954.99
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $61.66 / $371.54	Professional	26	$33.88	$61.66	$371.54
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $107.15 / $758.58	Professional	TC	$27.54	$107.15	$758.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $229.09	Professional		$32.36	$33.11	$229.09
Quartz Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $154.88 / $371.54	Professional		$83.18	$154.88	$371.54
Quartz Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $891.25 / $891.25	Facility		$181.97	$891.25	$891.25
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $263.03 / $263.03	Facility	26	$100.00	$263.03	$263.03
Quartz Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $588.84 / $954.99	Professional		$60.26	$588.84	$954.99
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $158.49 / $371.54	Professional	26	$29.51	$158.49	$371.54
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $467.74 / $758.58	Professional	TC	$26.92	$467.74	$758.58
Security Health Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $263.03 / $446.68	Professional		$173.78	$263.03	$446.68
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $112.20 / $141.25	Professional	26	$93.33	$112.20	$141.25
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $100.00 / $144.54	Professional	TC	$79.43	$100.00	$144.54
United Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $117.49 / $263.03	Professional		$58.88	$117.49	$263.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $44.67 / $104.71	Professional	26	$32.36	$44.67	$104.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $53.70 / $204.17	Professional	TC	$25.70	$53.70	$204.17