Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $134.69 / $144.52 / $154.88	Facility	26	$134.69	$144.52	$154.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $137.58 / $194.20 / $439.20	Professional		$137.58	$194.20	$439.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.19 / $134.69 / $545.29	Professional	26	$55.19	$134.69	$545.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $68.44 / $114.82 / $212.80	Professional	TC	$68.44	$114.82	$212.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $136.66 / $321.99 / $890.88	Professional		$136.66	$321.99	$890.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $67.34 / $156.09 / $441.72	Professional	26	$67.34	$156.09	$441.72
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $69.31 / $165.89 / $453.00	Professional	TC	$69.31	$165.89	$453.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $61.39 / $98.03 / $224.32	Professional		$61.39	$98.03	$224.32
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $180.22 / $210.61 / $279.91	Facility	26	$180.22	$210.61	$279.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $181.78 / $489.09 / $555.79	Professional		$181.78	$489.09	$555.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.00 / $241.34 / $274.25	Professional	26	$69.00	$241.34	$274.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $82.21 / $247.79 / $281.58	Professional	TC	$82.21	$247.79	$281.58
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $646.64 / $646.64 / $646.64	Facility	26	$646.64	$646.64	$646.64
Medica Facility/Professional Professional Modifier Low / Median / High Price $157.01 / $386.73 / $1,406.40	Professional		$157.01	$386.73	$1,406.40
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $69.22 / $176.65 / $439.49	Professional	26	$69.22	$176.65	$439.49
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $84.89 / $199.86 / $1,140.03	Professional	TC	$84.89	$199.86	$1,140.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.09 / $116.22 / $253.20	Professional		$50.09	$116.22	$253.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $245.70 / $359.86 / $569.54	Professional		$245.70	$359.86	$569.54
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $163.95 / $646.64 / $646.64	Facility	26	$163.95	$646.64	$646.64
Quartz Facility/Professional Professional Modifier Low / Median / High Price $206.00 / $850.00 / $1,406.40	Professional		$206.00	$850.00	$1,406.40
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $101.64 / $363.25 / $439.49	Professional	26	$101.64	$363.25	$439.49
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $104.36 / $675.00 / $1,140.03	Professional	TC	$104.36	$675.00	$1,140.03
Security Health Facility/Professional Professional Modifier Low / Median / High Price $402.85 / $871.50 / $971.04	Professional		$402.85	$871.50	$971.04
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $188.39 / $214.14 / $308.30	Professional	26	$188.39	$214.14	$308.30
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $182.29 / $214.46 / $406.85	Professional	TC	$182.29	$214.46	$406.85
United Facility/Professional Professional Modifier Low / Median / High Price $157.01 / $363.00 / $780.85	Professional		$157.01	$363.00	$780.85
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.36 / $166.18 / $318.39	Professional	26	$72.36	$166.18	$318.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $84.64 / $194.82 / $455.66	Professional	TC	$84.64	$194.82	$455.66