Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.88 / $62.49 / $255.85	Professional		$31.88	$62.49	$255.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.56 / $31.29 / $243.38	Professional	26	$8.56	$31.29	$243.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.32 / $46.06 / $187.00	Professional	TC	$23.32	$46.06	$187.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.76 / $122.29 / $265.17	Professional		$41.76	$122.29	$265.17
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.24 / $32.93 / $71.59	Professional	26	$12.24	$32.93	$71.59
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.52 / $98.44 / $187.45	Professional	TC	$29.52	$98.44	$187.45
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10.32 / $29.21 / $47.42	Facility		$10.32	$29.21	$47.42
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.32 / $29.21 / $47.42	Professional		$10.32	$29.21	$47.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $135.84 / $154.36 / $219.11	Facility		$135.84	$154.36	$219.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.70 / $38.29 / $54.35	Facility	26	$33.70	$38.29	$54.35
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $102.14 / $116.07 / $164.75	Facility	TC	$102.14	$116.07	$164.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.88 / $59.13 / $131.75	Professional		$19.88	$59.13	$131.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.53 / $15.02 / $35.34	Professional	26	$5.53	$15.02	$35.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.60 / $44.35 / $93.63	Professional	TC	$14.60	$44.35	$93.63
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $30.43 / $57.75 / $168.35	Facility		$30.43	$57.75	$168.35
Medica Facility/Professional Facility Modifier Low / Median / High Price $30.43 / $57.75 / $179.63	Facility		$30.43	$57.75	$179.63
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $164.16 / $164.16 / $164.16	Facility	TC	$164.16	$164.16	$164.16
Medica Facility/Professional Professional Modifier Low / Median / High Price $31.74 / $68.00 / $360.92	Professional		$31.74	$68.00	$360.92
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.29 / $34.75 / $191.54	Professional	26	$10.29	$34.75	$191.54
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.78 / $54.01 / $268.14	Professional	TC	$23.78	$54.01	$268.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.61 / $58.40 / $106.03	Professional		$14.61	$58.40	$106.03
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $30.43 / $57.75 / $168.35	Facility		$30.43	$57.75	$168.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $76.80 / $100.97 / $219.64	Professional		$76.80	$100.97	$219.64
Quartz Facility/Professional Facility Modifier Low / Median / High Price $94.66 / $94.66 / $208.80	Facility		$94.66	$94.66	$208.80
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Quartz Facility/Professional Facility Modifier TC Low / Median / High Price $100.00 / $100.00 / $164.16	Facility	TC	$100.00	$100.00	$164.16
Quartz Facility/Professional Professional Modifier Low / Median / High Price $22.00 / $294.22 / $360.92	Professional		$22.00	$294.22	$360.92
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $5.87 / $94.10 / $191.54	Professional	26	$5.87	$94.10	$191.54
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $15.19 / $241.06 / $268.14	Professional	TC	$15.19	$241.06	$268.14
Security Health Facility/Professional Professional Modifier Low / Median / High Price $94.25 / $94.25 / $220.15	Professional		$94.25	$94.25	$220.15
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.54 / $18.54 / $54.42	Professional	26	$18.54	$18.54	$54.42
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $69.83 / $69.83 / $99.92	Professional	TC	$69.83	$69.83	$99.92
United Facility/Professional Professional Modifier Low / Median / High Price $29.87 / $39.68 / $128.96	Professional		$29.87	$39.68	$128.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.58 / $11.48 / $37.31	Professional	26	$8.58	$11.48	$37.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.56 / $28.20 / $91.65	Professional	TC	$22.56	$28.20	$91.65