Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $117.49 / $117.49 / $128.82	Facility	26	$117.49	$117.49	$128.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $275.42 / $549.54	Professional		$208.93	$275.42	$549.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $67.61 / $208.93	Professional	26	$51.29	$67.61	$208.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $190.55 / $436.52	Professional	TC	$141.25	$190.55	$436.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $338.84 / $1,202.26	Professional		$218.78	$338.84	$1,202.26
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $91.20 / $316.23	Professional	26	$58.88	$91.20	$316.23
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $245.47 / $891.25	Professional	TC	$158.49	$245.47	$891.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $158.49 / $186.21 / $295.12	Facility	26	$158.49	$186.21	$295.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $707.95 / $912.01	Professional		$316.23	$707.95	$912.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $194.98 / $245.47	Professional	26	$89.13	$194.98	$245.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $524.81 / $660.69	Professional	TC	$223.87	$524.81	$660.69
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $501.19 / $616.60	Professional		$436.52	$501.19	$616.60
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $141.25 / $169.82	Professional	26	$120.23	$141.25	$169.82
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $316.23 / $363.08 / $436.52	Professional	TC	$316.23	$363.08	$436.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $676.08 / $3,388.44	Professional		$263.03	$676.08	$3,388.44
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $134.90 / $436.52	Professional	26	$67.61	$134.90	$436.52
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $512.86 / $3,019.95	Professional	TC	$190.55	$512.86	$3,019.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $478.63	Professional		$32.36	$33.11	$478.63
Quartz Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $645.65 / $977.24	Professional		$354.81	$645.65	$977.24
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $141.25 / $141.25 / $562.34	Facility	26	$141.25	$141.25	$562.34
Quartz Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $2,511.89 / $3,388.44	Professional		$354.81	$2,511.89	$3,388.44
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $309.03 / $436.52	Professional	26	$89.13	$309.03	$436.52
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $2,344.23 / $3,090.30	Professional	TC	$257.04	$2,344.23	$3,090.30
Security Health Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $1,380.38 / $1,778.28	Professional		$707.95	$1,380.38	$1,778.28
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $204.17 / $213.80 / $338.84	Professional	26	$204.17	$213.80	$338.84
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $467.74 / $512.86 / $912.01	Professional	TC	$467.74	$512.86	$912.01
United Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $537.03 / $1,047.13	Professional		$239.88	$537.03	$1,047.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $114.82 / $234.42	Professional	26	$64.57	$114.82	$234.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $389.05 / $812.83	Professional	TC	$169.82	$389.05	$812.83