Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $71.15 / $98.82 / $99.60	Facility	26	$71.15	$98.82	$99.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $149.99 / $274.55 / $701.00	Professional		$149.99	$274.55	$701.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.25 / $71.15 / $241.18	Professional	26	$44.25	$71.15	$241.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $101.97 / $162.43 / $586.92	Professional	TC	$101.97	$162.43	$586.92
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $153.21 / $353.54 / $982.83	Professional		$153.21	$353.54	$982.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.90 / $106.30 / $296.12	Professional	26	$45.90	$106.30	$296.12
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $107.31 / $247.25 / $686.71	Professional	TC	$107.31	$247.25	$686.71
CareSource Facility/Professional Professional Modifier Low / Median / High Price $52.45 / $133.38 / $215.01	Professional		$52.45	$133.38	$215.01
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $126.65 / $143.93 / $193.14	Facility	26	$126.65	$143.93	$193.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $196.73 / $557.95 / $634.04	Professional		$196.73	$557.95	$634.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.64 / $165.57 / $188.15	Professional	26	$54.64	$165.57	$188.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $136.44 / $392.38 / $445.89	Professional	TC	$136.44	$392.38	$445.89
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $211.96 / $211.96 / $367.00	Facility	26	$211.96	$211.96	$367.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $181.84 / $408.78 / $1,024.30	Professional		$181.84	$408.78	$1,024.30
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $56.32 / $130.34 / $300.10	Professional	26	$56.32	$130.34	$300.10
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $125.52 / $290.27 / $724.19	Professional	TC	$125.52	$290.27	$724.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.25 / $116.28 / $309.23	Professional		$55.25	$116.28	$309.23
Quartz Facility/Professional Professional Modifier Low / Median / High Price $308.75 / $374.68 / $674.66	Professional		$308.75	$374.68	$674.66
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $112.48 / $211.96 / $211.96	Facility	26	$112.48	$211.96	$211.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $242.65 / $817.55 / $1,024.30	Professional		$242.65	$817.55	$1,024.30
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $72.06 / $246.70 / $300.10	Professional	26	$72.06	$246.70	$300.10
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $170.59 / $570.85 / $724.19	Professional	TC	$170.59	$570.85	$724.19
Security Health Facility/Professional Professional Modifier Low / Median / High Price $400.36 / $994.16 / $994.16	Professional		$400.36	$994.16	$994.16
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $116.83 / $136.27 / $224.39	Professional	26	$116.83	$136.27	$224.39
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $263.43 / $283.52 / $521.98	Professional	TC	$263.43	$283.52	$521.98
United Facility/Professional Professional Modifier Low / Median / High Price $174.72 / $372.80 / $716.58	Professional		$174.72	$372.80	$716.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.93 / $112.50 / $216.23	Professional	26	$53.93	$112.50	$216.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $125.52 / $275.14 / $567.63	Professional	TC	$125.52	$275.14	$567.63