Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $124.01 / $124.01 / $174.87	Facility	26	$124.01	$124.01	$174.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $478.37 / $676.72 / $2,745.00	Professional		$478.37	$676.72	$2,745.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.54 / $130.86 / $701.10	Professional	26	$75.54	$130.86	$701.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $393.95 / $552.71 / $2,382.79	Professional	TC	$393.95	$552.71	$2,382.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $436.59 / $957.30 / $2,833.80	Professional		$436.59	$957.30	$2,833.80
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $80.01 / $162.41 / $506.42	Professional	26	$80.01	$162.41	$506.42
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $356.59 / $796.51 / $2,321.41	Professional	TC	$356.59	$796.51	$2,321.41
CareSource Facility/Professional Professional Modifier Low / Median / High Price $108.05 / $429.64 / $537.67	Professional		$108.05	$429.64	$537.67
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $218.07 / $254.83 / $390.92	Facility	26	$218.07	$254.83	$390.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $593.69 / $2,002.41 / $2,275.46	Professional		$593.69	$2,002.41	$2,275.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $106.39 / $368.78 / $419.06	Professional	26	$106.39	$368.78	$419.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $481.08 / $1,633.63 / $1,856.40	Professional	TC	$481.08	$1,633.63	$1,856.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $534.44 / $1,149.41 / $4,499.00	Professional		$534.44	$1,149.41	$4,499.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $91.21 / $196.88 / $1,350.00	Professional	26	$91.21	$196.88	$1,350.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $440.78 / $953.58 / $3,149.00	Professional	TC	$440.78	$953.58	$3,149.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $81.30 / $316.95 / $847.54	Professional		$81.30	$316.95	$847.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $817.35 / $1,042.79 / $1,904.51	Professional		$817.35	$1,042.79	$1,904.51
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $1,357.70 / $1,357.70 / $1,357.70	Facility	26	$1,357.70	$1,357.70	$1,357.70
Quartz Facility/Professional Professional Modifier Low / Median / High Price $663.36 / $2,416.44 / $4,499.00	Professional		$663.36	$2,416.44	$4,499.00
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $137.94 / $411.70 / $1,350.00	Professional	26	$137.94	$411.70	$1,350.00
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $611.02 / $2,004.75 / $3,149.00	Professional	TC	$611.02	$2,004.75	$3,149.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,723.68 / $2,749.57 / $2,749.57	Professional		$1,723.68	$2,749.57	$2,749.57
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $267.04 / $282.74 / $465.02	Professional	26	$267.04	$282.74	$465.02
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $530.15 / $1,449.30 / $2,706.33	Professional	TC	$530.15	$1,449.30	$2,706.33
United Facility/Professional Professional Modifier Low / Median / High Price $511.20 / $966.58 / $2,225.79	Professional		$511.20	$966.58	$2,225.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $89.96 / $195.83 / $388.40	Professional	26	$89.96	$195.83	$388.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $438.24 / $801.90 / $1,862.94	Professional	TC	$438.24	$801.90	$1,862.94