Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $338.84 / $478.63 / $575.44	Facility	26	$338.84	$478.63	$575.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $676.08 / $2,290.87	Professional		$407.38	$676.08	$2,290.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $208.93 / $416.87 / $912.01	Professional	26	$208.93	$416.87	$912.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $309.03 / $660.69	Professional	TC	$208.93	$309.03	$660.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $707.95 / $2,630.27	Professional		$457.09	$707.95	$2,630.27
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $218.78 / $338.84 / $1,230.27	Professional	26	$218.78	$338.84	$1,230.27
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $380.19 / $1,380.38	Professional	TC	$245.47	$380.19	$1,380.38
CareSource Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $309.03 / $602.56	Professional		$295.12	$309.03	$602.56
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $602.56 / $691.83 / $1,122.02	Facility	26	$602.56	$691.83	$1,122.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $1,584.89 / $2,511.89	Professional		$707.95	$1,584.89	$2,511.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $331.13 / $724.44 / $1,174.90	Professional	26	$331.13	$724.44	$1,174.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $371.54 / $1,047.13 / $1,318.26	Professional	TC	$371.54	$1,047.13	$1,318.26
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,122.02 / $1,348.96	Professional		$977.24	$1,122.02	$1,348.96
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $457.09 / $524.81 / $645.65	Professional	26	$457.09	$524.81	$645.65
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $512.86 / $602.56 / $724.44	Professional	TC	$512.86	$602.56	$724.44
Medica Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $1,288.25 / $7,413.10	Professional		$575.44	$1,288.25	$7,413.10
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $263.03 / $524.81 / $1,698.24	Professional	26	$263.03	$524.81	$1,698.24
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $758.58 / $6,165.95	Professional	TC	$275.42	$758.58	$6,165.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $660.69	Professional		$32.36	$33.11	$660.69
Quartz Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,412.54 / $3,235.94	Professional		$776.25	$1,412.54	$3,235.94
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $537.03 / $1,412.54 / $1,412.54	Facility	26	$537.03	$1,412.54	$1,412.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $4,265.80 / $7,585.78	Professional		$794.33	$4,265.80	$7,585.78
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $331.13 / $1,122.02 / $1,698.24	Professional	26	$331.13	$1,122.02	$1,698.24
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $416.87 / $3,548.13 / $6,456.54	Professional	TC	$416.87	$3,548.13	$6,456.54
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $2,951.21 / $3,630.78	Professional		$1,659.59	$2,951.21	$3,630.78
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $645.65 / $758.58 / $1,348.96	Professional	26	$645.65	$758.58	$1,348.96
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $891.25 / $1,096.48 / $2,290.87	Professional	TC	$891.25	$1,096.48	$2,290.87
United Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $977.24 / $2,454.71	Professional		$512.86	$977.24	$2,454.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $234.42 / $426.58 / $1,000.00	Professional	26	$234.42	$426.58	$1,000.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $512.86 / $1,584.89	Professional	TC	$263.03	$512.86	$1,584.89