Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $160.66 / $160.66 / $227.68	Facility	26	$160.66	$160.66	$227.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $153.49 / $208.40 / $764.25	Professional		$153.49	$208.40	$764.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $98.46 / $160.66 / $609.00	Professional	26	$98.46	$160.66	$609.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $34.02 / $72.90 / $170.82	Professional	TC	$34.02	$72.90	$170.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $130.28 / $272.93 / $841.41	Professional		$130.28	$272.93	$841.41
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $103.66 / $210.42 / $657.90	Professional	26	$103.66	$210.42	$657.90
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.61 / $58.92 / $184.54	Professional	TC	$24.61	$58.92	$184.54
CareSource Facility/Professional Professional Modifier Low / Median / High Price $46.83 / $140.72 / $187.54	Professional		$46.83	$140.72	$187.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $283.85 / $331.70 / $508.84	Facility	26	$283.85	$331.70	$508.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $212.36 / $637.79 / $724.78	Professional		$212.36	$637.79	$724.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $137.57 / $478.78 / $544.05	Professional	26	$137.57	$478.78	$544.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $55.51 / $159.03 / $180.71	Professional	TC	$55.51	$159.03	$180.71
Medica Facility/Professional Professional Modifier Low / Median / High Price $157.54 / $410.87 / $3,014.42	Professional		$157.54	$410.87	$3,014.42
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $121.60 / $257.48 / $1,056.82	Professional	26	$121.60	$257.48	$1,056.82
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $29.33 / $103.87 / $2,488.46	Professional	TC	$29.33	$103.87	$2,488.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.81 / $93.89 / $247.51	Professional		$28.81	$93.89	$247.51
Quartz Facility/Professional Professional Modifier Low / Median / High Price $286.00 / $428.47 / $1,280.20	Professional		$286.00	$428.47	$1,280.20
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $722.52 / $722.52 / $722.52	Facility	26	$722.52	$722.52	$722.52
Quartz Facility/Professional Professional Modifier Low / Median / High Price $238.56 / $1,661.15 / $3,014.42	Professional		$238.56	$1,661.15	$3,014.42
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $179.08 / $534.20 / $1,056.82	Professional	26	$179.08	$534.20	$1,056.82
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $59.48 / $1,335.49 / $2,488.46	Professional	TC	$59.48	$1,335.49	$2,488.46
Security Health Facility/Professional Professional Modifier Low / Median / High Price $485.41 / $875.83 / $909.79	Professional		$485.41	$875.83	$909.79
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $134.94 / $356.77 / $624.94	Professional	26	$134.94	$356.77	$624.94
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $115.77 / $128.63 / $284.83	Professional	TC	$115.77	$128.63	$284.83
United Facility/Professional Professional Modifier Low / Median / High Price $148.50 / $328.20 / $953.09	Professional		$148.50	$328.20	$953.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $119.61 / $229.79 / $502.68	Professional	26	$119.61	$229.79	$502.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.33 / $67.61 / $731.90	Professional	TC	$29.33	$67.61	$731.90