Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.59 / $213.29 / $921.35	Professional		$67.59	$213.29	$921.35
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.46 / $199.50 / $886.24	Professional	26	$32.46	$199.50	$886.24
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $25.93 / $33.96 / $74.92	Professional	52	$25.93	$33.96	$74.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.99 / $67.03 / $742.90	Professional	TC	$25.99	$67.03	$742.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.20 / $210.45 / $449.27	Professional		$70.20	$210.45	$449.27
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $39.96 / $109.47 / $238.06	Professional	26	$39.96	$109.47	$238.06
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.24 / $103.35 / $192.02	Professional	TC	$30.24	$103.35	$192.02
CareSource Facility/Professional Facility Modifier Low / Median / High Price $32.92 / $41.12 / $80.63	Facility		$32.92	$41.12	$80.63
CareSource Facility/Professional Professional Modifier Low / Median / High Price $32.92 / $41.12 / $80.63	Professional		$32.92	$41.12	$80.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $228.51 / $259.67 / $368.57	Facility		$228.51	$259.67	$368.57
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $113.73 / $129.24 / $183.44	Facility	26	$113.73	$129.24	$183.44
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $114.78 / $130.43 / $185.14	Facility	TC	$114.78	$130.43	$185.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.22 / $107.11 / $230.11	Professional		$34.22	$107.11	$230.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.84 / $49.89 / $117.38	Professional	26	$17.84	$49.89	$117.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.46 / $50.35 / $112.75	Professional	TC	$16.46	$50.35	$112.75
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $51.86 / $84.12 / $274.85	Facility		$51.86	$84.12	$274.85
Medica Facility/Professional Facility Modifier Low / Median / High Price $51.86 / $90.71 / $274.85	Facility		$51.86	$90.71	$274.85
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $163.47 / $163.47 / $163.47	Facility	26	$163.47	$163.47	$163.47
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $216.27 / $216.27 / $216.27	Facility	TC	$216.27	$216.27	$216.27
Medica Facility/Professional Professional Modifier Low / Median / High Price $63.37 / $128.29 / $547.54	Professional		$63.37	$128.29	$547.54
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $145.13 / $287.76	Professional	26	$38.02	$145.13	$287.76
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $28.96 / $97.21 / $349.50	Professional	TC	$28.96	$97.21	$349.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $17.14 / $65.00 / $127.41	Professional		$17.14	$65.00	$127.41
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $51.86 / $84.12 / $274.85	Facility		$51.86	$84.12	$274.85
Quartz Facility/Professional Professional Modifier Low / Median / High Price $129.00 / $169.59 / $296.47	Professional		$129.00	$169.59	$296.47
Quartz Facility/Professional Facility Modifier Low / Median / High Price $146.00 / $146.00 / $369.57	Facility		$146.00	$146.00	$369.57
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $163.47	Facility	26	$100.00	$100.00	$163.47
Quartz Facility/Professional Facility Modifier TC Low / Median / High Price $100.00 / $100.00 / $216.27	Facility	TC	$100.00	$100.00	$216.27
Quartz Facility/Professional Professional Modifier Low / Median / High Price $89.41 / $496.17 / $547.54	Professional		$89.41	$496.17	$547.54
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $19.22 / $192.45 / $292.24	Professional	26	$19.22	$192.45	$292.24
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $18.12 / $314.70 / $349.50	Professional	TC	$18.12	$314.70	$349.50
Security Health Facility/Professional Professional Modifier Low / Median / High Price $140.08 / $195.46 / $371.39	Professional		$140.08	$195.46	$371.39
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $64.31 / $64.31 / $160.44	Professional	26	$64.31	$64.31	$160.44
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $37.39 / $37.39 / $101.15	Professional	TC	$37.39	$37.39	$101.15
United Facility/Professional Professional Modifier Low / Median / High Price $53.71 / $68.73 / $250.10	Professional		$53.71	$68.73	$250.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.62 / $38.49 / $124.54	Professional	26	$26.62	$38.49	$124.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.20 / $44.96 / $110.72	Professional	TC	$24.20	$44.96	$110.72