Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $164.20 / $228.33 / $228.33	Facility	26	$164.20	$228.33	$228.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $341.76 / $615.62 / $4,003.50	Professional		$341.76	$615.62	$4,003.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.05 / $228.33 / $1,232.50	Professional	26	$104.05	$228.33	$1,232.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $220.06 / $373.40 / $1,409.08	Professional	TC	$220.06	$373.40	$1,409.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $346.84 / $842.54 / $2,270.58	Professional		$346.84	$842.54	$2,270.58
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $105.94 / $244.51 / $687.10	Professional	26	$105.94	$244.51	$687.10
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $240.91 / $598.03 / $1,583.47	Professional	TC	$240.91	$598.03	$1,583.47
CareSource Facility/Professional Professional Modifier Low / Median / High Price $121.43 / $284.58 / $471.00	Professional		$121.43	$284.58	$471.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $285.66 / $333.81 / $443.66	Facility	26	$285.66	$333.81	$443.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $470.38 / $1,239.81 / $1,408.88	Professional		$470.38	$1,239.81	$1,408.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $128.91 / $381.60 / $433.64	Professional	26	$128.91	$381.60	$433.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $327.10 / $858.21 / $975.24	Professional	TC	$327.10	$858.21	$975.24
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $1,020.08 / $1,020.08 / $1,020.08	Facility	26	$1,020.08	$1,020.08	$1,020.08
Medica Facility/Professional Professional Modifier Low / Median / High Price $496.00 / $1,203.50 / $2,611.53	Professional		$496.00	$1,203.50	$2,611.53
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $117.65 / $288.32 / $687.65	Professional	26	$117.65	$288.32	$687.65
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $343.43 / $881.21 / $2,172.92	Professional	TC	$343.43	$881.21	$2,172.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $80.06 / $206.16 / $601.90	Professional		$80.06	$206.16	$601.90
Quartz Facility/Professional Professional Modifier Low / Median / High Price $624.60 / $821.14 / $1,182.16	Professional		$624.60	$821.14	$1,182.16
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $259.23 / $1,020.08 / $1,020.08	Facility	26	$259.23	$1,020.08	$1,020.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $522.16 / $1,922.70 / $2,337.81	Professional		$522.16	$1,922.70	$2,337.81
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $160.71 / $567.00 / $687.65	Professional	26	$160.71	$567.00	$687.65
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $361.46 / $1,355.70 / $1,650.16	Professional	TC	$361.46	$1,355.70	$1,650.16
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,030.21 / $2,209.17 / $2,689.81	Professional		$2,030.21	$2,209.17	$2,689.81
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $549.95 / $687.44 / $817.64	Professional	26	$549.95	$687.44	$817.64
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,341.16 / $1,701.04 / $2,023.22	Professional	TC	$1,341.16	$1,701.04	$2,023.22
United Facility/Professional Professional Modifier Low / Median / High Price $87.90 / $1,184.11 / $2,913.49	Professional		$87.90	$1,184.11	$2,913.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $109.30 / $244.95 / $496.98	Professional	26	$109.30	$244.95	$496.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $325.37 / $732.08 / $1,997.65	Professional	TC	$325.37	$732.08	$1,997.65