Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.95 / $80.12 / $80.75	Facility	26	$40.95	$80.12	$80.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.39 / $188.08 / $553.00	Professional		$109.39	$188.08	$553.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.00 / $62.47 / $209.92	Professional	26	$36.00	$62.47	$209.92
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $442.56 / $442.56 / $442.56	Professional	52	$442.56	$442.56	$442.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $81.01 / $121.99 / $444.60	Professional	TC	$81.01	$121.99	$444.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $121.34 / $279.23 / $777.87	Professional		$121.34	$279.23	$777.87
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.21 / $85.97 / $239.49	Professional	26	$37.21	$85.97	$239.49
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $84.13 / $193.26 / $538.38	Professional	TC	$84.13	$193.26	$538.38
CareSource Facility/Professional Professional Modifier Low / Median / High Price $42.58 / $104.73 / $170.45	Professional		$42.58	$104.73	$170.45
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $101.33 / $115.15 / $156.75	Facility	26	$101.33	$115.15	$156.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $154.97 / $441.25 / $501.43	Professional		$154.97	$441.25	$501.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.98 / $134.84 / $153.22	Professional	26	$43.98	$134.84	$153.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $106.71 / $306.37 / $348.15	Professional	TC	$106.71	$306.37	$348.15
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $172.60 / $172.60 / $259.00	Facility	26	$172.60	$172.60	$259.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $144.21 / $329.48 / $810.58	Professional		$144.21	$329.48	$810.58
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $45.79 / $108.64 / $242.65	Professional	26	$45.79	$108.64	$242.65
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $98.42 / $227.55 / $567.92	Professional	TC	$98.42	$227.55	$567.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.25 / $102.63 / $250.42	Professional		$55.25	$102.63	$250.42
Quartz Facility/Professional Professional Modifier Low / Median / High Price $245.05 / $297.38 / $533.55	Professional		$245.05	$297.38	$533.55
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $91.60 / $172.60 / $172.60	Facility	26	$91.60	$172.60	$172.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $192.79 / $647.95 / $810.58	Professional		$192.79	$647.95	$810.58
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $58.03 / $200.45 / $242.65	Professional	26	$58.03	$200.45	$242.65
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $134.13 / $447.55 / $567.92	Professional	TC	$134.13	$447.55	$567.92
Security Health Facility/Professional Professional Modifier Low / Median / High Price $315.38 / $786.24 / $786.24	Professional		$315.38	$786.24	$786.24
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $93.92 / $107.87 / $181.50	Professional	26	$93.92	$107.87	$181.50
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $207.52 / $221.55 / $407.98	Professional	TC	$207.52	$221.55	$407.98
United Facility/Professional Professional Modifier Low / Median / High Price $144.21 / $295.89 / $606.83	Professional		$144.21	$295.89	$606.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.99 / $95.00 / $220.39	Professional	26	$56.99	$95.00	$220.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $95.85 / $204.06 / $392.23	Professional	TC	$95.85	$204.06	$392.23