Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $632.86 / $632.86 / $894.76	Facility	26	$632.86	$632.86	$894.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,889.42 / $2,740.72 / $10,616.00	Professional		$1,889.42	$2,740.72	$10,616.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $387.09 / $649.26 / $2,408.23	Professional	26	$387.09	$649.26	$2,408.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $1,502.32 / $2,107.85 / $8,392.00	Professional	TC	$1,502.32	$2,107.85	$8,392.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,768.20 / $4,105.01 / $11,244.15	Professional		$1,768.20	$4,105.01	$11,244.15
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $408.30 / $905.16 / $2,610.48	Professional	26	$408.30	$905.16	$2,610.48
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $1,359.90 / $2,866.18 / $8,633.65	Professional	TC	$1,359.90	$2,866.18	$8,633.65
CareSource Facility/Professional Professional Modifier Low / Median / High Price $553.76 / $1,715.34 / $2,269.10	Professional		$553.76	$1,715.34	$2,269.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $1,112.88 / $1,300.49 / $1,994.99	Facility	26	$1,112.88	$1,300.49	$1,994.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,507.71 / $8,237.44 / $9,360.73	Professional		$2,507.71	$8,237.44	$9,360.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $520.40 / $1,881.94 / $2,138.56	Professional	26	$520.40	$1,881.94	$2,138.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $1,930.74 / $6,355.50 / $7,222.16	Professional	TC	$1,930.74	$6,355.50	$7,222.16
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,171.90 / $4,404.18 / $13,450.23	Professional		$2,171.90	$4,404.18	$13,450.23
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $470.93 / $997.93 / $2,845.07	Professional	26	$470.93	$997.93	$2,845.07
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $1,576.16 / $3,407.62 / $9,015.64	Professional	TC	$1,576.16	$3,407.62	$9,015.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $323.88 / $1,267.10 / $3,398.95	Professional		$323.88	$1,267.10	$3,398.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,509.39 / $4,384.14 / $7,834.71	Professional		$2,509.39	$4,384.14	$7,834.71
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $1,924.04 / $1,924.04 / $1,924.04	Facility	26	$1,924.04	$1,924.04	$1,924.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,834.19 / $9,259.10 / $13,450.23	Professional		$2,834.19	$9,259.10	$13,450.23
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $703.91 / $2,095.10 / $2,845.07	Professional	26	$703.91	$2,095.10	$2,845.07
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $2,377.16 / $7,164.05 / $9,015.64	Professional	TC	$2,377.16	$7,164.05	$9,015.64
Security Health Facility/Professional Professional Modifier Low / Median / High Price $6,521.65 / $11,311.25 / $11,311.25	Professional		$6,521.65	$11,311.25	$11,311.25
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1,188.81 / $1,400.59 / $2,390.39	Professional	26	$1,188.81	$1,400.59	$2,390.39
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $4,520.25 / $5,121.06 / $9,476.27	Professional	TC	$4,520.25	$5,121.06	$9,476.27
United Facility/Professional Professional Modifier Low / Median / High Price $2,156.08 / $4,334.89 / $8,735.04	Professional		$2,156.08	$4,334.89	$8,735.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $457.99 / $950.02 / $1,858.11	Professional	26	$457.99	$950.02	$1,858.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $1,576.16 / $3,367.96 / $6,758.52	Professional	TC	$1,576.16	$3,367.96	$6,758.52