Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $575.44 / $851.14	Facility		$257.04	$575.44	$851.14
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.81 / $45.71 / $67.61	Facility	26	$39.81	$45.71	$67.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $173.78 / $870.96	Professional		$77.62	$173.78	$870.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $47.86 / $208.93	Professional	26	$23.99	$47.86	$208.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $89.13 / $218.78	Professional	TC	$54.95	$89.13	$218.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $138.04 / $602.56	Professional		$97.72	$138.04	$602.56
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $38.02 / $138.04	Professional	26	$25.70	$38.02	$138.04
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $100.00 / $467.74	Professional	TC	$70.79	$100.00	$467.74
CareSource Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $173.78 / $234.42	Professional		$60.26	$173.78	$234.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $371.54 / $588.84	Facility		$316.23	$371.54	$588.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $81.28 / $131.83	Facility	26	$70.79	$81.28	$131.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $416.87 / $467.74	Professional		$162.18	$416.87	$467.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $95.50 / $107.15	Professional	26	$38.02	$95.50	$107.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $323.59 / $363.08	Professional	TC	$125.89	$323.59	$363.08
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $141.25 / $229.09	Facility		$104.71	$141.25	$229.09
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $251.19 / $316.23	Professional		$208.93	$251.19	$316.23
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $60.26 / $74.13	Professional	26	$47.86	$60.26	$74.13
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $190.55 / $245.47	Professional	TC	$158.49	$190.55	$245.47
Medica Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $281.84 / $575.44	Facility		$117.49	$281.84	$575.44
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $562.34 / $562.34 / $562.34	Facility	26	$562.34	$562.34	$562.34
Medica Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $131.83 / $524.81	Professional		$85.11	$131.83	$524.81
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $43.65 / $131.83	Professional	26	$26.92	$43.65	$131.83
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $93.33 / $338.84	Professional	TC	$57.54	$93.33	$338.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $104.71	Professional		$32.36	$33.11	$104.71
Quartz Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $288.40 / $407.38	Professional		$95.50	$288.40	$407.38
Quartz Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $263.03 / $758.58	Facility		$263.03	$263.03	$758.58
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $61.66 / $61.66 / $169.82	Facility	26	$61.66	$61.66	$169.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $524.81 / $758.58	Professional		$162.18	$524.81	$758.58
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $138.04 / $169.82	Professional	26	$38.02	$138.04	$169.82
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $389.05 / $588.84	Professional	TC	$125.89	$389.05	$588.84
Security Health Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $724.44 / $741.31	Professional		$181.97	$724.44	$741.31
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $54.95 / $125.89	Professional	26	$26.30	$54.95	$125.89
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $125.89 / $295.12	Professional	TC	$114.82	$125.89	$295.12
United Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $131.83 / $363.08	Professional		$85.11	$131.83	$363.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $34.67 / $100.00	Professional	26	$26.30	$34.67	$100.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $95.50 / $263.03	Professional	TC	$57.54	$95.50	$263.03