Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $338.84 / $338.84 / $478.63	Facility	26	$338.84	$338.84	$478.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $602.56 / $1,862.09	Professional		$389.05	$602.56	$1,862.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $199.53 / $371.54 / $1,000.00	Professional	26	$199.53	$371.54	$1,000.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $269.15 / $549.54	Professional	TC	$194.98	$269.15	$549.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $691.83 / $2,454.71	Professional		$446.68	$691.83	$2,454.71
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 $229.09 / $354.81 / $1,318.26	Professional	TC	$229.09	$354.81	$1,318.26
CareSource Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $295.12 / $588.84	Professional		$295.12	$295.12	$588.84
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 $691.83 / $1,548.82 / $2,454.71	Professional		$691.83	$1,548.82	$2,454.71
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 $354.81 / $812.83 / $1,258.93	Professional	TC	$354.81	$812.83	$1,258.93
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $1,096.48 / $1,318.26	Professional		$954.99	$1,096.48	$1,318.26
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 $489.78 / $616.60 / $741.31	Professional	TC	$489.78	$616.60	$741.31
Medica Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $1,071.52 / $2,884.03	Professional		$537.03	$1,071.52	$2,884.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $251.19 / $501.19 / $1,412.54	Professional	26	$251.19	$501.19	$1,412.54
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $549.54 / $1,479.11	Professional	TC	$281.84	$549.54	$1,479.11
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 $478.63 / $1,122.02 / $2,041.74	Professional		$478.63	$1,122.02	$2,041.74
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $537.03 / $537.03 / $1,412.54	Facility	26	$537.03	$537.03	$1,412.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $2,398.83 / $2,884.03	Professional		$691.83	$2,398.83	$2,884.03
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $331.13 / $1,122.02 / $1,412.54	Professional	26	$331.13	$1,122.02	$1,412.54
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $354.81 / $1,258.93 / $1,479.11	Professional	TC	$354.81	$1,258.93	$1,479.11
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $2,884.03 / $3,548.13	Professional		$1,548.82	$2,884.03	$3,548.13
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $676.08 / $758.58 / $1,288.25	Professional	26	$676.08	$758.58	$1,288.25
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $812.83 / $954.99 / $1,445.44	Professional	TC	$812.83	$954.99	$1,445.44
United Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $912.01 / $2,089.30	Professional		$501.19	$912.01	$2,089.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $239.88 / $426.58 / $1,000.00	Professional	26	$239.88	$426.58	$1,000.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $478.63 / $1,096.48	Professional	TC	$263.03	$478.63	$1,096.48