Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.04 / $79.34 / $277.00	Professional		$61.04	$79.34	$277.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.09 / $25.17 / $221.40	Professional	26	$9.09	$25.17	$221.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $49.50 / $67.62 / $152.81	Professional	TC	$49.50	$67.62	$152.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.80 / $183.01 / $407.69	Professional		$28.80	$183.01	$407.69
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.04 / $34.36 / $70.17	Professional	26	$5.04	$34.36	$70.17
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.76 / $170.53 / $334.08	Professional	TC	$23.76	$170.53	$334.08
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10.97 / $65.11 / $92.41	Facility		$10.97	$65.11	$92.41
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.97 / $65.11 / $91.30	Professional		$10.97	$65.11	$91.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $265.36 / $301.55 / $428.02	Facility		$265.36	$301.55	$428.02
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.79 / $40.69 / $57.75	Facility	26	$35.79	$40.69	$57.75
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $229.56 / $260.86 / $370.27	Facility	TC	$229.56	$260.86	$370.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.04 / $111.77 / $243.32	Professional		$38.04	$111.77	$243.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.88 / $15.90 / $37.54	Professional	26	$5.88	$15.90	$37.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.56 / $95.76 / $207.25	Professional	TC	$32.56	$95.76	$207.25
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $24.26 / $91.30 / $228.24	Facility		$24.26	$91.30	$228.24
Medica Facility/Professional Facility Modifier Low / Median / High Price $24.26 / $94.23 / $228.24	Facility		$24.26	$94.23	$228.24
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 $319.41 / $319.41 / $319.41	Facility	TC	$319.41	$319.41	$319.41
Medica Facility/Professional Professional Modifier Low / Median / High Price $55.71 / $92.87 / $514.55	Professional		$55.71	$92.87	$514.55
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.76 / $26.11 / $87.52	Professional	26	$9.76	$26.11	$87.52
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $47.34 / $84.29 / $439.92	Professional	TC	$47.34	$84.29	$439.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.56 / $58.40 / $221.72	Professional		$32.56	$58.40	$221.72
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $24.26 / $91.30 / $228.24	Facility		$24.26	$91.30	$228.24
Quartz Facility/Professional Professional Modifier Low / Median / High Price $74.67 / $189.74 / $266.12	Professional		$74.67	$189.74	$266.12
Quartz Facility/Professional Facility Modifier Low / Median / High Price $158.50 / $158.50 / $372.39	Facility		$158.50	$158.50	$372.39
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 $135.91 / $135.91 / $319.41	Facility	TC	$135.91	$135.91	$319.41
Quartz Facility/Professional Professional Modifier Low / Median / High Price $43.02 / $366.40 / $514.55	Professional		$43.02	$366.40	$514.55
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $6.22 / $61.00 / $87.52	Professional	26	$6.22	$61.00	$87.52
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $33.97 / $305.39 / $439.92	Professional	TC	$33.97	$305.39	$439.92
Security Health Facility/Professional Professional Modifier Low / Median / High Price $55.62 / $55.62 / $425.66	Professional		$55.62	$55.62	$425.66
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.09 / $13.09 / $43.64	Professional	26	$13.09	$13.09	$43.64
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $41.55 / $41.55 / $198.03	Professional	TC	$41.55	$41.55	$198.03
United Facility/Professional Professional Modifier Low / Median / High Price $49.62 / $73.28 / $220.06	Professional		$49.62	$73.28	$220.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.07 / $12.20 / $39.04	Professional	26	$9.07	$12.20	$39.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $42.79 / $61.08 / $189.47	Professional	TC	$42.79	$61.08	$189.47