Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.37 / $96.97 / $277.52	Professional		$74.37	$96.97	$277.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.31 / $71.44 / $502.90	Professional	26	$46.31	$71.44	$502.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.42 / $33.15 / $87.43	Professional	TC	$28.42	$33.15	$87.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.89 / $282.51 / $556.26	Professional		$39.89	$282.51	$556.26
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.64 / $178.08 / $366.48	Professional	26	$26.64	$178.08	$366.48
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $13.48 / $104.42 / $189.42	Professional	TC	$13.48	$104.42	$189.42
CareSource Facility/Professional Facility Modifier Low / Median / High Price $37.56 / $56.97 / $113.44	Facility		$37.56	$56.97	$113.44
CareSource Facility/Professional Professional Modifier Low / Median / High Price $37.56 / $62.67 / $113.44	Professional		$37.56	$62.67	$113.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $321.17 / $364.97 / $518.04	Facility		$321.17	$364.97	$518.04
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $188.49 / $214.20 / $304.02	Facility	26	$188.49	$214.20	$304.02
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $132.68 / $150.77 / $214.01	Facility	TC	$132.68	$150.77	$214.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.10 / $140.43 / $321.14	Professional		$48.10	$140.43	$321.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.80 / $83.15 / $194.04	Professional	26	$29.80	$83.15	$194.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.78 / $55.21 / $121.68	Professional	TC	$18.78	$55.21	$121.68
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $75.48 / $118.70 / $283.58	Facility		$75.48	$118.70	$283.58
Medica Facility/Professional Facility Modifier Low / Median / High Price $75.48 / $118.70 / $293.01	Facility		$75.48	$118.70	$293.01
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $272.47 / $272.47 / $272.47	Facility	26	$272.47	$272.47	$272.47
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $184.67 / $184.67 / $184.67	Facility	TC	$184.67	$184.67	$184.67
Medica Facility/Professional Professional Modifier Low / Median / High Price $69.11 / $133.47 / $643.49	Professional		$69.11	$133.47	$643.49
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $47.51 / $122.39 / $383.71	Professional	26	$47.51	$122.39	$383.71
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $24.79 / $36.77 / $350.03	Professional	TC	$24.79	$36.77	$350.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.49 / $65.00 / $211.27	Professional		$28.49	$65.00	$211.27
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $75.48 / $118.70 / $283.58	Facility		$75.48	$118.70	$283.58
Quartz Facility/Professional Professional Modifier Low / Median / High Price $181.20 / $232.93 / $338.75	Professional		$181.20	$232.93	$338.75
Quartz Facility/Professional Facility Modifier Low / Median / High Price $195.20 / $195.20 / $457.19	Facility		$195.20	$195.20	$457.19
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $116.62 / $116.62 / $272.47	Facility	26	$116.62	$116.62	$272.47
Quartz Facility/Professional Facility Modifier TC Low / Median / High Price $100.00 / $100.00 / $184.67	Facility	TC	$100.00	$100.00	$184.67
Quartz Facility/Professional Professional Modifier Low / Median / High Price $53.63 / $483.60 / $643.49	Professional		$53.63	$483.60	$643.49
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $31.88 / $318.64 / $383.71	Professional	26	$31.88	$318.64	$383.71
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $19.77 / $165.00 / $350.03	Professional	TC	$19.77	$165.00	$350.03
Security Health Facility/Professional Professional Modifier Low / Median / High Price $232.16 / $274.70 / $524.21	Professional		$232.16	$274.70	$524.21
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $100.82 / $100.82 / $230.45	Professional	26	$100.82	$100.82	$230.45
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $23.28 / $23.28 / $110.96	Professional	TC	$23.28	$23.28	$110.96
United Facility/Professional Professional Modifier Low / Median / High Price $68.01 / $96.72 / $278.55	Professional		$68.01	$96.72	$278.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.05 / $63.73 / $186.48	Professional	26	$44.05	$63.73	$186.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.79 / $32.99 / $107.22	Professional	TC	$24.79	$32.99	$107.22