Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $300.18 / $419.48 / $764.81	Professional		$300.18	$419.48	$764.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $108.21 / $166.91 / $747.72	Professional	26	$108.21	$166.91	$747.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $181.94 / $285.73 / $834.83	Professional	TC	$181.94	$285.73	$834.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $410.04 / $1,258.73 / $2,603.75	Professional		$410.04	$1,258.73	$2,603.75
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $155.88 / $422.30 / $918.34	Professional	26	$155.88	$422.30	$918.34
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $254.16 / $836.43 / $1,613.91	Professional	TC	$254.16	$836.43	$1,613.91
CareSource Facility/Professional Professional Modifier Low / Median / High Price $132.47 / $294.00 / $479.69	Professional		$132.47	$294.00	$479.69
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $440.17 / $500.19 / $709.97	Facility	26	$440.17	$500.19	$709.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.87 / $584.88 / $1,358.65	Professional		$199.87	$584.88	$1,358.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.08 / $193.09 / $452.98	Professional	26	$69.08	$193.09	$452.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $133.63 / $397.25 / $875.71	Professional	TC	$133.63	$397.25	$875.71
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $632.78 / $632.78 / $632.78	Facility	26	$632.78	$632.78	$632.78
Medica Facility/Professional Professional Modifier Low / Median / High Price $282.66 / $433.73 / $2,755.28	Professional		$282.66	$433.73	$2,755.28
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $109.93 / $241.40 / $895.79	Professional	26	$109.93	$241.40	$895.79
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $165.00 / $260.29 / $1,859.49	Professional	TC	$165.00	$260.29	$1,859.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.40 / $70.00 / $958.07	Professional		$58.40	$70.00	$958.07
Quartz Facility/Professional Professional Modifier Low / Median / High Price $603.96 / $990.35 / $1,413.30	Professional		$603.96	$990.35	$1,413.30
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $272.24 / $272.24 / $632.78	Facility	26	$272.24	$272.24	$632.78
Quartz Facility/Professional Professional Modifier Low / Median / High Price $209.88 / $2,045.95 / $2,755.28	Professional		$209.88	$2,045.95	$2,755.28
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $74.43 / $744.50 / $895.79	Professional	26	$74.43	$744.50	$895.79
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $139.75 / $1,301.50 / $1,859.49	Professional	TC	$139.75	$1,301.50	$1,859.49
Security Health Facility/Professional Professional Modifier Low / Median / High Price $339.90 / $339.90 / $2,232.27	Professional		$339.90	$339.90	$2,232.27
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $192.93 / $192.93 / $542.34	Professional	26	$192.93	$192.93	$542.34
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $184.87 / $184.87 / $881.05	Professional	TC	$184.87	$184.87	$881.05
United Facility/Professional Professional Modifier Low / Median / High Price $279.07 / $409.19 / $1,466.51	Professional		$279.07	$409.19	$1,466.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $92.00 / $148.90 / $676.04	Professional	26	$92.00	$148.90	$676.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $155.96 / $260.29 / $775.40	Professional	TC	$155.96	$260.29	$775.40