Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $114.82 / $158.49 / $194.98	Facility	26	$114.82	$158.49	$194.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $616.60 / $2,691.53	Professional		$371.54	$616.60	$2,691.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $109.65 / $457.09	Professional	26	$69.18	$109.65	$457.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $380.19 / $691.83	Professional	TC	$288.40	$380.19	$691.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $660.69 / $2,398.83	Professional		$426.58	$660.69	$2,398.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $114.82 / $407.38	Professional	26	$74.13	$114.82	$407.38
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $346.74 / $537.03 / $1,995.26	Professional	TC	$346.74	$537.03	$1,995.26
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $199.53 / $229.09 / $371.54	Facility	26	$199.53	$229.09	$371.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $1,548.82 / $1,778.28	Professional		$645.65	$1,548.82	$1,778.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $269.15 / $309.03	Professional	26	$112.20	$269.15	$309.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $537.03 / $1,288.25 / $1,445.44	Professional	TC	$537.03	$1,288.25	$1,445.44
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $977.24 / $1,230.27	Professional		$831.76	$977.24	$1,230.27
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $147.91 / $173.78 / $208.93	Professional	26	$147.91	$173.78	$208.93
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $691.83 / $812.83 / $1,047.13	Professional	TC	$691.83	$812.83	$1,047.13
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $512.86 / $512.86 / $512.86	Facility	26	$512.86	$512.86	$512.86
Medica Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $1,071.52 / $2,884.03	Professional		$501.19	$1,071.52	$2,884.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $204.17 / $478.63	Professional	26	$87.10	$204.17	$478.63
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $416.87 / $870.96 / $2,398.83	Professional	TC	$416.87	$870.96	$2,398.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $676.08	Professional		$32.36	$33.11	$676.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $1,023.29 / $1,905.46	Professional		$575.44	$1,023.29	$1,905.46
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $173.78 / $478.63 / $478.63	Facility	26	$173.78	$478.63	$478.63
Quartz Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $2,290.87 / $2,884.03	Professional		$602.56	$2,290.87	$2,884.03
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $371.54 / $478.63	Professional	26	$109.65	$371.54	$478.63
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $501.19 / $1,905.46 / $2,398.83	Professional	TC	$501.19	$1,905.46	$2,398.83
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $2,691.53 / $3,548.13	Professional		$1,258.93	$2,691.53	$3,548.13
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $208.93 / $229.09 / $436.52	Professional	26	$208.93	$229.09	$436.52
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,023.29 / $1,047.13 / $2,344.23	Professional	TC	$1,023.29	$1,047.13	$2,344.23
United Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $912.01 / $2,041.74	Professional		$489.78	$912.01	$2,041.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $158.49 / $346.74	Professional	26	$81.28	$158.49	$346.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $407.38 / $758.58 / $1,698.24	Professional	TC	$407.38	$758.58	$1,698.24