Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.23 / $79.43 / $97.72	Facility	26	$56.23	$79.43	$97.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $309.03 / $1,023.29	Professional		$199.53	$309.03	$1,023.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $58.88 / $131.83	Professional	26	$33.11	$58.88	$131.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $251.19 / $602.56	Professional	TC	$158.49	$251.19	$602.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $407.38 / $1,479.11	Professional		$257.04	$407.38	$1,479.11
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $57.54 / $204.17	Professional	26	$36.31	$57.54	$204.17
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $346.74 / $1,258.93	Professional	TC	$223.87	$346.74	$1,258.93
CareSource Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $275.42 / $323.59	Professional		$48.98	$275.42	$323.59
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $117.49 / $186.21	Facility	26	$100.00	$117.49	$186.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $776.25 / $1,412.54	Professional		$389.05	$776.25	$1,412.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $120.23 / $194.98	Professional	26	$54.95	$120.23	$194.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $331.13 / $676.08 / $1,202.26	Professional	TC	$331.13	$676.08	$1,202.26
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $630.96 / $758.58	Professional		$537.03	$630.96	$758.58
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $87.10 / $104.71	Professional	26	$75.86	$87.10	$104.71
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $457.09 / $537.03 / $645.65	Professional	TC	$457.09	$537.03	$645.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $575.44 / $2,398.83	Professional		$251.19	$575.44	$2,398.83
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $85.11 / $724.44	Professional	26	$40.74	$85.11	$724.44
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $467.74 / $1,659.59	Professional	TC	$213.80	$467.74	$1,659.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $251.19	Professional		$32.36	$33.11	$251.19
Quartz Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $645.65 / $1,174.90	Professional		$436.52	$645.65	$1,174.90
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $467.74 / $467.74	Facility	26	$100.00	$467.74	$467.74
Quartz Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $1,348.96 / $2,398.83	Professional		$389.05	$1,348.96	$2,398.83
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $186.21 / $724.44	Professional	26	$54.95	$186.21	$724.44
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $331.13 / $1,148.15 / $1,659.59	Professional	TC	$331.13	$1,148.15	$1,659.59
Security Health Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,659.59 / $2,137.96	Professional		$891.25	$1,659.59	$2,137.96
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $123.03 / $208.93	Professional	26	$123.03	$123.03	$208.93
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $794.33 / $1,122.02	Professional	TC	$288.40	$794.33	$1,122.02
United Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $446.68 / $1,000.00	Professional		$223.87	$446.68	$1,000.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $67.61 / $165.96	Professional	26	$38.90	$67.61	$165.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $363.08 / $954.99	Professional	TC	$181.97	$363.08	$954.99