Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $198.93 / $277.72 / $901.00	Professional		$198.93	$277.72	$901.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.36 / $229.72 / $852.53	Professional	26	$61.36	$229.72	$852.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $131.18 / $201.99 / $546.26	Professional	TC	$131.18	$201.99	$546.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $270.00 / $825.72 / $1,714.50	Professional		$270.00	$825.72	$1,714.50
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $87.84 / $239.65 / $521.15	Professional	26	$87.84	$239.65	$521.15
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $182.16 / $589.20 / $1,156.71	Professional	TC	$182.16	$589.20	$1,156.71
CareSource Facility/Professional Facility Modifier Low / Median / High Price $74.97 / $192.04 / $320.41	Facility		$74.97	$192.04	$320.41
CareSource Facility/Professional Professional Modifier Low / Median / High Price $74.97 / $192.04 / $320.41	Professional		$74.97	$192.04	$320.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $922.45 / $1,048.24 / $1,487.89	Facility		$922.45	$1,048.24	$1,487.89
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $249.57 / $283.60 / $402.54	Facility	26	$249.57	$283.60	$402.54
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $672.89 / $764.64 / $1,085.33	Facility	TC	$672.89	$764.64	$1,085.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $133.51 / $391.42 / $892.20	Professional		$133.51	$391.42	$892.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.28 / $109.48 / $256.74	Professional	26	$39.28	$109.48	$256.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $96.02 / $285.04 / $619.04	Professional	TC	$96.02	$285.04	$619.04
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $135.07 / $334.94 / $801.03	Facility		$135.07	$334.94	$801.03
Medica Facility/Professional Facility Modifier Low / Median / High Price $135.07 / $334.94 / $834.39	Facility		$135.07	$334.94	$834.39
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $358.77 / $358.77 / $358.77	Facility	26	$358.77	$358.77	$358.77
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $943.11 / $943.11 / $943.11	Facility	TC	$943.11	$943.11	$943.11
Medica Facility/Professional Professional Modifier Low / Median / High Price $186.30 / $303.19 / $1,813.36	Professional		$186.30	$303.19	$1,813.36
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $74.97 / $248.65 / $509.36	Professional	26	$74.97	$248.65	$509.36
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $125.40 / $209.17 / $1,303.99	Professional	TC	$125.40	$209.17	$1,303.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $85.00 / $684.76	Professional		$50.00	$85.00	$684.76
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $135.07 / $334.94 / $801.03	Facility		$135.07	$334.94	$801.03
Quartz Facility/Professional Professional Modifier Low / Median / High Price $461.20 / $663.32 / $930.35	Professional		$461.20	$663.32	$930.35
Quartz Facility/Professional Facility Modifier Low / Median / High Price $552.10 / $552.10 / $1,301.88	Facility		$552.10	$552.10	$1,301.88
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $154.30 / $154.30 / $358.77	Facility	26	$154.30	$154.30	$358.77
Quartz Facility/Professional Facility Modifier TC Low / Median / High Price $397.80 / $397.80 / $943.11	Facility	TC	$397.80	$397.80	$943.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $151.49 / $1,343.55 / $1,813.36	Professional		$151.49	$1,343.55	$1,813.36
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $42.37 / $422.25 / $509.36	Professional	26	$42.37	$422.25	$509.36
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $99.45 / $921.35 / $1,303.99	Professional	TC	$99.45	$921.35	$1,303.99
Security Health Facility/Professional Professional Modifier Low / Median / High Price $236.90 / $411.40 / $1,482.66	Professional		$236.90	$411.40	$1,482.66
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $134.99 / $134.99 / $329.12	Professional	26	$134.99	$134.99	$329.12
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $130.19 / $130.19 / $620.47	Professional	TC	$130.19	$130.19	$620.47
United Facility/Professional Professional Modifier Low / Median / High Price $176.40 / $268.70 / $773.88	Professional		$176.40	$268.70	$773.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.33 / $84.45 / $243.22	Professional	26	$58.33	$84.45	$243.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $125.40 / $184.26 / $530.66	Professional	TC	$125.40	$184.26	$530.66