Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.98 / $88.20 / $153.16	Professional		$67.98	$88.20	$153.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.09 / $57.26 / $240.98	Professional	26	$46.09	$57.26	$240.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.67 / $31.16 / $58.83	Professional	TC	$22.67	$31.16	$58.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.79 / $271.01 / $553.77	Professional		$38.79	$271.01	$553.77
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.64 / $178.69 / $366.58	Professional	26	$26.64	$178.69	$366.58
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $14.84 / $92.24 / $166.50	Professional	TC	$14.84	$92.24	$166.50
CareSource Facility/Professional Professional Modifier Low / Median / High Price $28.90 / $61.12 / $102.68	Professional		$28.90	$61.12	$102.68
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $187.44 / $213.00 / $302.33	Facility	26	$187.44	$213.00	$302.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.34 / $122.99 / $294.11	Professional		$45.34	$122.99	$294.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.63 / $82.69 / $193.01	Professional	26	$29.63	$82.69	$193.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.71 / $43.89 / $94.83	Professional	TC	$15.71	$43.89	$94.83
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $270.97 / $270.97 / $270.97	Facility	26	$270.97	$270.97	$270.97
Medica Facility/Professional Professional Modifier Low / Median / High Price $62.99 / $102.85 / $587.10	Professional		$62.99	$102.85	$587.10
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $47.03 / $87.98 / $381.48	Professional	26	$47.03	$87.98	$381.48
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $19.94 / $34.72 / $205.55	Professional	TC	$19.94	$34.72	$205.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.34 / $70.00 / $211.34	Professional		$28.34	$70.00	$211.34
Quartz Facility/Professional Professional Modifier Low / Median / High Price $45.42 / $210.56 / $306.22	Professional		$45.42	$210.56	$306.22
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $116.00 / $116.00 / $270.97	Facility	26	$116.00	$116.00	$270.97
Quartz Facility/Professional Professional Modifier Low / Median / High Price $46.24 / $446.53 / $587.10	Professional		$46.24	$446.53	$587.10
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $30.41 / $318.75 / $381.48	Professional	26	$30.41	$318.75	$381.48
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $15.83 / $149.84 / $205.55	Professional	TC	$15.83	$149.84	$205.55
Security Health Facility/Professional Professional Modifier Low / Median / High Price $117.94 / $268.74 / $474.69	Professional		$117.94	$268.74	$474.69
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $75.13 / $75.13 / $246.84	Professional	26	$75.13	$75.13	$246.84
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.71 / $20.71 / $98.70	Professional	TC	$20.71	$20.71	$98.70
United Facility/Professional Professional Modifier Low / Median / High Price $61.24 / $88.86 / $254.92	Professional		$61.24	$88.86	$254.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.05 / $63.75 / $186.54	Professional	26	$44.05	$63.75	$186.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.94 / $25.11 / $72.31	Professional	TC	$19.94	$25.11	$72.31