Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.57 / $66.20 / $145.41	Professional		$47.57	$66.20	$145.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.84 / $24.58 / $253.58	Professional	26	$16.84	$24.58	$253.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $31.22 / $43.02 / $99.64	Professional	TC	$31.22	$43.02	$99.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.32 / $186.15 / $368.24	Professional		$28.32	$186.15	$368.24
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.50 / $65.05 / $131.37	Professional	26	$9.50	$65.05	$131.37
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.73 / $129.07 / $228.56	Professional	TC	$19.73	$129.07	$228.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $20.53 / $44.68 / $78.25	Facility		$20.53	$44.68	$78.25
CareSource Facility/Professional Professional Modifier Low / Median / High Price $20.53 / $46.93 / $78.25	Professional		$20.53	$46.93	$78.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $220.08 / $250.09 / $354.99	Facility		$220.08	$250.09	$354.99
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.45 / $77.78 / $110.40	Facility	26	$68.45	$77.78	$110.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.61 / $93.25 / $196.93	Professional		$32.61	$93.25	$196.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.80 / $29.16 / $66.31	Professional	26	$10.80	$29.16	$66.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.42 / $64.79 / $134.13	Professional	TC	$21.42	$64.79	$134.13
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $47.57 / $78.25 / $203.73	Facility		$47.57	$78.25	$203.73
Medica Facility/Professional Facility Modifier Low / Median / High Price $47.57 / $88.03 / $204.84	Facility		$47.57	$88.03	$204.84
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $113.52 / $113.52 / $113.52	Facility	26	$113.52	$113.52	$113.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $48.23 / $83.20 / $407.64	Professional		$48.23	$83.20	$407.64
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $20.53 / $70.53 / $272.70	Professional	26	$20.53	$70.53	$272.70
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $29.95 / $60.06 / $268.50	Professional	TC	$29.95	$60.06	$268.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $22.34 / $65.00 / $153.11	Professional		$22.34	$65.00	$153.11
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $47.57 / $78.25 / $203.73	Facility		$47.57	$78.25	$203.73
Quartz Facility/Professional Professional Modifier Low / Median / High Price $126.00 / $161.97 / $227.18	Professional		$126.00	$161.97	$227.18
Quartz Facility/Professional Facility Modifier Low / Median / High Price $131.68 / $131.68 / $317.91	Facility		$131.68	$131.68	$317.91
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $113.52	Facility	26	$100.00	$100.00	$113.52
Quartz Facility/Professional Professional Modifier Low / Median / High Price $34.04 / $345.76 / $407.64	Professional		$34.04	$345.76	$407.64
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $11.57 / $134.54 / $244.00	Professional	26	$11.57	$134.54	$244.00
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $22.35 / $211.22 / $268.50	Professional	TC	$22.35	$211.22	$268.50
Security Health Facility/Professional Professional Modifier Low / Median / High Price $70.81 / $176.09 / $353.59	Professional		$70.81	$176.09	$353.59
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.37 / $17.37 / $107.93	Professional	26	$17.37	$17.37	$107.93
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.43 / $28.43 / $135.49	Professional	TC	$28.43	$28.43	$135.49
United Facility/Professional Professional Modifier Low / Median / High Price $44.65 / $60.29 / $173.64	Professional		$44.65	$60.29	$173.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.37 / $22.85 / $74.17	Professional	26	$15.37	$22.85	$74.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.09 / $37.44 / $107.83	Professional	TC	$29.09	$37.44	$107.83