Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.54 / $52.70 / $152.27	Professional		$40.54	$52.70	$152.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.55 / $32.79 / $184.00	Professional	26	$25.55	$32.79	$184.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.60 / $19.89 / $41.18	Professional	TC	$14.60	$19.89	$41.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.62 / $154.34 / $315.91	Professional		$23.62	$154.34	$315.91
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.26 / $102.76 / $210.83	Professional	26	$15.26	$102.76	$210.83
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $8.35 / $53.56 / $105.08	Professional	TC	$8.35	$53.56	$105.08
CareSource Facility/Professional Professional Modifier Low / Median / High Price $20.23 / $35.90 / $63.44	Professional		$20.23	$35.90	$63.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $107.41 / $122.06 / $173.25	Facility	26	$107.41	$122.06	$173.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.49 / $74.42 / $178.94	Professional		$26.49	$74.42	$178.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.02 / $45.96 / $110.71	Professional	26	$17.02	$45.96	$110.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $10.11 / $29.33 / $61.50	Professional	TC	$10.11	$29.33	$61.50
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $155.94 / $155.94 / $155.94	Facility	26	$155.94	$155.94	$155.94
Medica Facility/Professional Professional Modifier Low / Median / High Price $39.45 / $75.80 / $473.28	Professional		$39.45	$75.80	$473.28
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $25.41 / $59.50 / $346.00	Professional	26	$25.41	$59.50	$346.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $14.29 / $23.12 / $330.22	Professional	TC	$14.29	$23.12	$330.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $16.32 / $65.00 / $121.24	Professional		$16.32	$65.00	$121.24
Quartz Facility/Professional Professional Modifier Low / Median / High Price $101.40 / $133.31 / $191.92	Professional		$101.40	$133.31	$191.92
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $155.94	Facility	26	$100.00	$100.00	$155.94
Quartz Facility/Professional Professional Modifier Low / Median / High Price $28.49 / $274.64 / $473.28	Professional		$28.49	$274.64	$473.28
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $18.16 / $183.30 / $346.00	Professional	26	$18.16	$183.30	$346.00
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $10.32 / $107.77 / $330.22	Professional	TC	$10.32	$107.77	$330.22
Security Health Facility/Professional Professional Modifier Low / Median / High Price $117.78 / $117.78 / $288.77	Professional		$117.78	$117.78	$288.77
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $70.31 / $70.31 / $132.61	Professional	26	$70.31	$70.31	$132.61
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $14.27 / $14.27 / $68.04	Professional	TC	$14.27	$14.27	$68.04
United Facility/Professional Professional Modifier Low / Median / High Price $39.22 / $54.93 / $158.19	Professional		$39.22	$54.93	$158.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.94 / $36.18 / $105.58	Professional	26	$24.94	$36.18	$105.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $13.31 / $18.27 / $63.17	Professional	TC	$13.31	$18.27	$63.17