Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $416.87 / $1,071.52	Professional		$316.23	$416.87	$1,071.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $407.38 / $870.96	Professional	26	$120.23	$407.38	$870.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $281.84 / $691.83	Professional	TC	$208.93	$281.84	$691.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $1,000.00 / $2,951.21	Professional		$407.38	$1,000.00	$2,951.21
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $154.88 / $331.13 / $1,023.29	Professional	26	$154.88	$331.13	$1,023.29
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $676.08 / $1,862.09	Professional	TC	$257.04	$676.08	$1,862.09
CareSource Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $309.03 / $630.96	Professional		$131.83	$309.03	$630.96
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $436.52 / $501.19 / $741.31	Facility	26	$436.52	$501.19	$741.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $575.44 / $1,348.96	Professional		$199.53	$575.44	$1,348.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $186.21 / $426.58	Professional	26	$66.07	$186.21	$426.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $389.05 / $870.96	Professional	TC	$83.18	$389.05	$870.96
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,174.90 / $1,288.25	Professional		$1,174.90	$1,174.90	$1,288.25
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $380.19 / $380.19 / $426.58	Professional	26	$380.19	$380.19	$426.58
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $776.25 / $776.25 / $870.96	Professional	TC	$776.25	$776.25	$870.96
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $630.96 / $630.96 / $630.96	Facility	26	$630.96	$630.96	$630.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $436.52 / $2,754.23	Professional		$281.84	$436.52	$2,754.23
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $245.47 / $891.25	Professional	26	$109.65	$245.47	$891.25
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $269.15 / $1,862.09	Professional	TC	$165.96	$269.15	$1,862.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $58.88 / $85.11	Professional		$32.36	$58.88	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $977.24 / $1,412.54	Professional		$602.56	$977.24	$1,412.54
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $263.03 / $263.03 / $891.25	Facility	26	$263.03	$263.03	$891.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $2,041.74 / $2,754.23	Professional		$199.53	$2,041.74	$2,754.23
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $741.31 / $891.25	Professional	26	$66.07	$741.31	$891.25
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $1,288.25 / $1,862.09	Professional	TC	$83.18	$1,288.25	$1,862.09
Security Health Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $602.56 / $2,238.72	Professional		$338.84	$602.56	$2,238.72
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $194.98 / $194.98 / $537.03	Professional	26	$194.98	$194.98	$537.03
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $186.21 / $891.25	Professional	TC	$186.21	$186.21	$891.25
United Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $407.38 / $870.96	Professional		$263.03	$407.38	$870.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $147.91 / $354.81	Professional	26	$91.20	$147.91	$354.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $251.19 / $562.34	Professional	TC	$151.36	$251.19	$562.34