Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $339.58 / $339.58 / $479.99	Facility	26	$339.58	$339.58	$479.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $499.36 / $715.97 / $2,825.37	Professional		$499.36	$715.97	$2,825.37
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $220.49 / $339.58 / $2,041.81	Professional	26	$220.49	$339.58	$2,041.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $268.26 / $376.39 / $1,531.85	Professional	TC	$268.26	$376.39	$1,531.85
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $461.92 / $944.26 / $2,918.77	Professional		$461.92	$944.26	$2,918.77
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $219.08 / $444.73 / $1,386.05	Professional	26	$219.08	$444.73	$1,386.05
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $242.83 / $501.00 / $1,526.30	Professional	TC	$242.83	$501.00	$1,526.30
CareSource Facility/Professional Professional Modifier Low / Median / High Price $296.73 / $311.30 / $608.04	Professional		$296.73	$311.30	$608.04
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $597.44 / $698.16 / $1,070.99	Facility	26	$597.44	$698.16	$1,070.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $701.76 / $2,153.62 / $2,447.30	Professional		$701.76	$2,153.62	$2,447.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $296.95 / $1,009.81 / $1,147.51	Professional	26	$296.95	$1,009.81	$1,147.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $371.10 / $1,143.81 / $1,299.79	Professional	TC	$371.10	$1,143.81	$1,299.79
Medica Facility/Professional Professional Modifier Low / Median / High Price $558.77 / $1,485.15 / $7,381.05	Professional		$558.77	$1,485.15	$7,381.05
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $256.76 / $569.90 / $1,699.00	Professional	26	$256.76	$569.90	$1,699.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $275.85 / $782.59 / $6,233.93	Professional	TC	$275.85	$782.59	$6,233.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $152.83 / $371.46 / $849.41	Professional		$152.83	$371.46	$849.41
Quartz Facility/Professional Professional Modifier Low / Median / High Price $948.35 / $1,420.77 / $3,214.13	Professional		$948.35	$1,420.77	$3,214.13
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $1,325.34 / $1,325.34 / $1,325.34	Facility	26	$1,325.34	$1,325.34	$1,325.34
Quartz Facility/Professional Professional Modifier Low / Median / High Price $805.52 / $4,055.29 / $7,381.05	Professional		$805.52	$4,055.29	$7,381.05
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $377.70 / $1,125.34 / $1,699.00	Professional	26	$377.70	$1,125.34	$1,699.00
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $427.82 / $3,346.13 / $6,233.93	Professional	TC	$427.82	$3,346.13	$6,233.93
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,644.65 / $2,957.20 / $2,957.20	Professional		$1,644.65	$2,957.20	$2,957.20
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $642.60 / $751.21 / $1,365.09	Professional	26	$642.60	$751.21	$1,365.09
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $893.43 / $1,130.46 / $2,275.88	Professional	TC	$893.43	$1,130.46	$2,275.88
United Facility/Professional Professional Modifier Low / Median / High Price $531.83 / $1,272.58 / $2,495.44	Professional		$531.83	$1,272.58	$2,495.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $255.98 / $535.29 / $1,315.38	Professional	26	$255.98	$535.29	$1,315.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $275.85 / $784.65 / $2,040.12	Professional	TC	$275.85	$784.65	$2,040.12