Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $575.44 / $1,000.00	Professional		$426.58	$575.44	$1,000.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $56.23 / $158.49	Professional	26	$43.65	$56.23	$158.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $380.19 / $501.19 / $912.01	Professional	TC	$380.19	$501.19	$912.01
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $1,348.96 / $3,715.35	Professional		$257.04	$1,348.96	$3,715.35
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $154.88 / $354.81	Professional	26	$24.55	$154.88	$354.81
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $1,479.11 / $3,311.31	Professional	TC	$234.42	$1,479.11	$3,311.31
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $177.83 / $199.53 / $295.12	Facility	26	$177.83	$199.53	$295.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $724.44 / $1,659.59	Professional		$354.81	$724.44	$1,659.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $74.13 / $169.82	Professional	26	$42.66	$74.13	$169.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $331.13 / $676.08 / $1,548.82	Professional	TC	$331.13	$676.08	$1,548.82
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $1,513.56 / $1,698.24	Professional		$1,513.56	$1,513.56	$1,698.24
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $154.88 / $154.88 / $173.78	Professional	26	$154.88	$154.88	$173.78
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $1,348.96 / $1,348.96 / $1,513.56	Professional	TC	$1,348.96	$1,348.96	$1,513.56
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $257.04 / $257.04 / $257.04	Facility	26	$257.04	$257.04	$257.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $602.56 / $3,981.07	Professional		$426.58	$602.56	$3,981.07
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $58.88 / $363.08	Professional	26	$40.74	$58.88	$363.08
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $371.54 / $537.03 / $3,548.13	Professional	TC	$371.54	$537.03	$3,548.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $64.57 / $102.33	Professional		$32.36	$64.57	$102.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,288.25 / $1,862.09	Professional		$912.01	$1,288.25	$1,862.09
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $107.15 / $107.15 / $363.08	Facility	26	$107.15	$107.15	$363.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $1,778.28 / $3,981.07	Professional		$354.81	$1,778.28	$3,981.07
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $173.78 / $363.08	Professional	26	$42.66	$173.78	$363.08
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $309.03 / $1,584.89 / $3,548.13	Professional	TC	$309.03	$1,584.89	$3,548.13
Security Health Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $1,778.28 / $3,019.95	Professional		$457.09	$1,778.28	$3,019.95
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $44.67 / $213.80	Professional	26	$44.67	$44.67	$213.80
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $416.87 / $416.87 / $1,995.26	Professional	TC	$416.87	$416.87	$1,995.26
United Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $562.34 / $1,380.38	Professional		$354.81	$562.34	$1,380.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $58.88 / $154.88	Professional	26	$36.31	$58.88	$154.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $501.19 / $1,202.26	Professional	TC	$323.59	$501.19	$1,202.26