Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $97.72 / $371.54	Professional		$57.54	$97.72	$371.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $61.66 / $371.54	Professional	26	$23.99	$61.66	$371.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $44.67 / $177.83	Professional	TC	$33.11	$44.67	$177.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $177.83 / $398.11	Professional		$40.74	$177.83	$398.11
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $85.11 / $177.83	Professional	26	$22.39	$85.11	$177.83
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $91.20 / $229.09	Professional	TC	$18.62	$91.20	$229.09
CareSource Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $46.77 / $85.11	Facility		$31.62	$46.77	$85.11
CareSource Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $60.26 / $97.72	Professional		$25.12	$60.26	$97.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $245.47 / $363.08	Facility		$218.78	$245.47	$363.08
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.11 / $95.50 / $141.25	Facility	26	$85.11	$95.50	$141.25
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $131.83 / $151.36 / $223.87	Facility	TC	$131.83	$151.36	$223.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $91.20 / $218.78	Professional		$31.62	$91.20	$218.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $41.69 / $89.13	Professional	26	$13.18	$41.69	$89.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $54.95 / $117.49	Professional	TC	$19.05	$54.95	$117.49
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $117.49 / $302.00	Facility		$57.54	$117.49	$302.00
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $186.21 / $204.17	Professional		$186.21	$186.21	$204.17
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $74.13 / $81.28	Professional	26	$74.13	$74.13	$81.28
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $109.65 / $123.03	Professional	TC	$109.65	$109.65	$123.03
Medica Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $117.49 / $363.08	Facility		$57.54	$117.49	$363.08
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $234.42 / $234.42 / $234.42	Facility	26	$234.42	$234.42	$234.42
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $186.21 / $186.21 / $186.21	Facility	TC	$186.21	$186.21	$186.21
Medica Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $107.15 / $645.65	Professional		$52.48	$107.15	$645.65
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $89.13 / $512.86	Professional	26	$26.92	$89.13	$512.86
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $60.26 / $309.03	Professional	TC	$30.20	$60.26	$309.03
Quartz Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $154.88 / $223.87	Professional		$114.82	$154.88	$223.87
Quartz Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $416.87	Facility		$173.78	$173.78	$416.87
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $97.72 / $97.72 / $234.42	Facility	26	$97.72	$97.72	$234.42
Quartz Facility/Professional Facility Modifier TC Low / Median / High Price $75.86 / $75.86 / $251.19	Facility	TC	$75.86	$75.86	$251.19
Quartz Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $489.78 / $645.65	Professional		$31.62	$489.78	$645.65
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $281.84 / $512.86	Professional	26	$12.59	$281.84	$512.86
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $208.93 / $323.59	Professional	TC	$19.05	$208.93	$323.59
Security Health Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $186.21 / $398.11	Professional		$112.20	$186.21	$398.11
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $64.57 / $128.82	Professional	26	$64.57	$64.57	$128.82
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $28.18 / $134.90	Professional	TC	$28.18	$28.18	$134.90
United Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $66.07 / $239.88	Professional		$42.66	$66.07	$239.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $31.62 / $107.15	Professional	26	$17.78	$31.62	$107.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $37.15 / $128.82	Professional	TC	$25.12	$37.15	$128.82