Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $114.82 / $114.82 / $158.49	Facility	26	$114.82	$114.82	$158.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $338.84 / $870.96	Professional		$194.98	$338.84	$870.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $114.82 / $346.74	Professional	26	$67.61	$114.82	$346.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $190.55 / $354.81	Professional	TC	$125.89	$190.55	$354.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $363.08 / $1,230.27	Professional		$223.87	$363.08	$1,230.27
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $114.82 / $407.38	Professional	26	$74.13	$114.82	$407.38
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $239.88 / $831.76	Professional	TC	$147.91	$239.88	$831.76
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $199.53 / $229.09 / $371.54	Facility	26	$199.53	$229.09	$371.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $524.81 / $912.01	Professional		$229.09	$524.81	$912.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $158.49 / $309.03	Professional	26	$69.18	$158.49	$309.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $354.81 / $616.60	Professional	TC	$151.36	$354.81	$616.60
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $489.78 / $660.69	Professional		$407.38	$489.78	$660.69
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $138.04 / $165.96 / $223.87	Professional	26	$138.04	$165.96	$223.87
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $323.59 / $436.52	Professional	TC	$269.15	$323.59	$436.52
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $707.95 / $707.95 / $707.95	Facility	26	$707.95	$707.95	$707.95
Medica Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $831.76 / $1,698.24	Professional		$295.12	$831.76	$1,698.24
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $154.88 / $478.63	Professional	26	$81.28	$154.88	$478.63
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $676.08 / $1,513.56	Professional	TC	$199.53	$676.08	$1,513.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $70.79	Professional		$32.36	$33.11	$70.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $512.86 / $741.31	Professional		$281.84	$512.86	$741.31
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $177.83 / $691.83 / $691.83	Facility	26	$177.83	$691.83	$691.83
Quartz Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $1,230.27 / $1,479.11	Professional		$302.00	$1,230.27	$1,479.11
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $398.11 / $478.63	Professional	26	$95.50	$398.11	$478.63
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $831.76 / $1,000.00	Professional	TC	$208.93	$831.76	$1,000.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,412.54 / $1,905.46	Professional		$1,258.93	$1,412.54	$1,905.46
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $354.81 / $478.63 / $588.84	Professional	26	$354.81	$478.63	$588.84
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $758.58 / $1,023.29 / $1,258.93	Professional	TC	$758.58	$1,023.29	$1,258.93
United Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $616.60 / $1,659.59	Professional		$263.03	$616.60	$1,659.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $131.83 / $288.40	Professional	26	$81.28	$131.83	$288.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $416.87 / $1,513.56	Professional	TC	$177.83	$416.87	$1,513.56