Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.72 / $75.78 / $343.65	Facility	26	$38.72	$75.78	$343.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $124.73 / $295.83 / $581.40	Professional		$124.73	$295.83	$581.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.17 / $62.38 / $189.20	Professional	26	$34.17	$62.38	$189.20
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $35.19 / $124.93 / $580.79	Professional	52	$35.19	$124.93	$580.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $87.32 / $142.59 / $553.85	Professional	TC	$87.32	$142.59	$553.85
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $124.15 / $285.66 / $791.66	Professional		$124.15	$285.66	$791.66
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.19 / $81.30 / $224.44	Professional	26	$35.19	$81.30	$224.44
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $88.96 / $204.35 / $567.22	Professional	TC	$88.96	$204.35	$567.22
CareSource Facility/Professional Professional Modifier Low / Median / High Price $40.27 / $110.24 / $174.05	Professional		$40.27	$110.24	$174.05
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $95.69 / $108.74 / $138.61	Facility	26	$95.69	$108.74	$138.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $159.05 / $450.34 / $511.75	Professional		$159.05	$450.34	$511.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.43 / $126.38 / $143.61	Professional	26	$41.43	$126.38	$143.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $112.73 / $323.95 / $368.14	Professional	TC	$112.73	$323.95	$368.14
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $163.47 / $163.47 / $180.00	Facility	26	$163.47	$163.47	$180.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $147.04 / $343.99 / $825.92	Professional		$147.04	$343.99	$825.92
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $45.12 / $117.68 / $227.63	Professional	26	$45.12	$117.68	$227.63
Medica Facility/Professional Professional Modifier 52 Low / Median / High Price $220.00 / $220.00 / $376.65	Professional	52	$220.00	$220.00	$376.65
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $104.08 / $246.18 / $598.35	Professional	TC	$104.08	$246.18	$598.35
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 $250.25 / $303.69 / $544.54	Professional		$250.25	$303.69	$544.54
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $85.85 / $163.47 / $163.47	Facility	26	$85.85	$163.47	$163.47
Quartz Facility/Professional Professional Modifier Low / Median / High Price $196.78 / $661.20 / $825.92	Professional		$196.78	$661.20	$825.92
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $55.08 / $188.00 / $227.63	Professional	26	$55.08	$188.00	$227.63
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $140.72 / $473.20 / $598.35	Professional	TC	$140.72	$473.20	$598.35
Security Health Facility/Professional Professional Modifier Low / Median / High Price $323.25 / $802.50 / $802.50	Professional		$323.25	$802.50	$802.50
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $89.14 / $103.26 / $127.06	Professional	26	$89.14	$103.26	$127.06
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $212.70 / $234.11 / $431.40	Professional	TC	$212.70	$234.11	$431.40
United Facility/Professional Professional Modifier Low / Median / High Price $147.04 / $302.83 / $579.54	Professional		$147.04	$302.83	$579.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.10 / $85.73 / $164.78	Professional	26	$41.10	$85.73	$164.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $99.97 / $215.78 / $451.36	Professional	TC	$99.97	$215.78	$451.36