Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.32 / $77.50 / $248.16	Professional		$48.32	$77.50	$248.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.77 / $31.79 / $337.90	Professional	26	$20.77	$31.79	$337.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.13 / $41.18 / $140.66	Professional	TC	$28.13	$41.18	$140.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.98 / $201.67 / $377.58	Professional		$40.98	$201.67	$377.58
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.46 / $93.32 / $171.83	Professional	26	$22.46	$93.32	$171.83
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.52 / $110.97 / $215.39	Professional	TC	$18.52	$110.97	$215.39
CareSource Facility/Professional Facility Modifier Low / Median / High Price $25.34 / $37.86 / $75.84	Facility		$25.34	$37.86	$75.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $25.34 / $41.66 / $75.84	Professional		$25.34	$41.66	$75.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $216.92 / $246.50 / $349.89	Facility		$216.92	$246.50	$349.89
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $84.24 / $95.73 / $135.88	Facility	26	$84.24	$95.73	$135.88
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $132.68 / $150.77 / $214.01	Facility	TC	$132.68	$150.77	$214.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.61 / $91.16 / $217.21	Professional		$31.61	$91.16	$217.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.25 / $41.96 / $86.79	Professional	26	$13.25	$41.96	$86.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.94 / $54.72 / $117.87	Professional	TC	$18.94	$54.72	$117.87
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $57.08 / $118.20 / $298.67	Facility		$57.08	$118.20	$298.67
Medica Facility/Professional Facility Modifier Low / Median / High Price $57.08 / $118.20 / $360.02	Facility		$57.08	$118.20	$360.02
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $234.18 / $234.18 / $234.18	Facility	26	$234.18	$234.18	$234.18
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $186.22 / $186.22 / $186.22	Facility	TC	$186.22	$186.22	$186.22
Medica Facility/Professional Professional Modifier Low / Median / High Price $52.52 / $105.04 / $641.00	Professional		$52.52	$105.04	$641.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $25.34 / $87.97 / $513.00	Professional	26	$25.34	$87.97	$513.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $29.96 / $51.68 / $312.17	Professional	TC	$29.96	$51.68	$312.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.94 / $70.00 / $135.87	Professional		$18.94	$70.00	$135.87
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $57.08 / $118.20 / $298.67	Facility		$57.08	$118.20	$298.67
Quartz Facility/Professional Professional Modifier Low / Median / High Price $121.80 / $156.57 / $227.71	Professional		$121.80	$156.57	$227.71
Quartz Facility/Professional Facility Modifier Low / Median / High Price $173.88 / $173.88 / $379.47	Facility		$173.88	$173.88	$379.47
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $97.18 / $97.18 / $234.18	Facility	26	$97.18	$97.18	$234.18
Quartz Facility/Professional Facility Modifier TC Low / Median / High Price $78.58 / $78.58 / $186.22	Facility	TC	$78.58	$78.58	$186.22
Quartz Facility/Professional Professional Modifier Low / Median / High Price $35.08 / $488.45 / $641.00	Professional		$35.08	$488.45	$641.00
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $14.23 / $280.75 / $513.00	Professional	26	$14.23	$280.75	$513.00
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $20.84 / $207.69 / $312.17	Professional	TC	$20.84	$207.69	$312.17
Security Health Facility/Professional Professional Modifier Low / Median / High Price $111.39 / $192.97 / $351.08	Professional		$111.39	$192.97	$351.08
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $64.06 / $64.06 / $127.53	Professional	26	$64.06	$64.06	$127.53
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 $45.98 / $65.65 / $233.77	Professional		$45.98	$65.65	$233.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.56 / $28.20 / $116.04	Professional	26	$22.56	$28.20	$116.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.92 / $37.45 / $123.74	Professional	TC	$25.92	$37.45	$123.74