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 $427.44 / $657.15 / $1,939.13	Professional		$427.44	$657.15	$1,939.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $213.33 / $359.02 / $1,278.00	Professional	26	$213.33	$359.02	$1,278.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $239.11 / $354.60 / $1,485.95	Professional	TC	$239.11	$354.60	$1,485.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $447.86 / $922.25 / $2,825.77	Professional		$447.86	$922.25	$2,825.77
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 $228.78 / $489.15 / $1,423.38	Professional	TC	$228.78	$489.15	$1,423.38
CareSource Facility/Professional Professional Modifier Low / Median / High Price $296.73 / $298.52 / $595.26	Professional		$296.73	$298.52	$595.26
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $598.34 / $699.21 / $1,072.60	Facility	26	$598.34	$699.21	$1,072.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $645.34 / $2,098.00 / $2,384.09	Professional		$645.34	$2,098.00	$2,384.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $292.43 / $1,011.26 / $1,149.16	Professional	26	$292.43	$1,011.26	$1,149.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $336.73 / $1,086.73 / $1,234.93	Professional	TC	$336.73	$1,086.73	$1,234.93
Medica Facility/Professional Professional Modifier Low / Median / High Price $530.66 / $1,186.59 / $2,895.04	Professional		$530.66	$1,186.59	$2,895.04
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $255.98 / $535.29 / $1,405.16	Professional	26	$255.98	$535.29	$1,405.16
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $274.69 / $593.54 / $1,489.88	Professional	TC	$274.69	$593.54	$1,489.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $133.73 / $369.80 / $840.05	Professional		$133.73	$369.80	$840.05
Quartz Facility/Professional Professional Modifier Low / Median / High Price $478.47 / $1,125.61 / $1,995.42	Professional		$478.47	$1,125.61	$1,995.42
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $1,030.91 / $1,030.91 / $1,030.91	Facility	26	$1,030.91	$1,030.91	$1,030.91
Quartz Facility/Professional Professional Modifier Low / Median / High Price $695.04 / $2,373.19 / $2,895.04	Professional		$695.04	$2,373.19	$2,895.04
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $335.02 / $1,125.34 / $1,405.16	Professional	26	$335.02	$1,125.34	$1,405.16
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $360.01 / $1,247.90 / $1,489.88	Professional	TC	$360.01	$1,247.90	$1,489.88
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,700.43 / $2,880.85 / $2,880.85	Professional		$1,700.43	$2,880.85	$2,880.85
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $676.09 / $751.21 / $1,284.66	Professional	26	$676.09	$751.21	$1,284.66
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $806.84 / $949.22 / $1,712.83	Professional	TC	$806.84	$949.22	$1,712.83
United Facility/Professional Professional Modifier Low / Median / High Price $530.66 / $1,082.18 / $2,238.88	Professional		$530.66	$1,082.18	$2,238.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $255.98 / $458.30 / $997.88	Professional	26	$255.98	$458.30	$997.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $274.69 / $569.02 / $1,177.22	Professional	TC	$274.69	$569.02	$1,177.22