Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.78 / $100.16 / $939.04	Professional		$59.78	$100.16	$939.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.66 / $115.50 / $642.76	Professional	26	$20.66	$115.50	$642.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $41.00 / $67.59 / $633.83	Professional	TC	$41.00	$67.59	$633.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.86 / $243.47 / $518.75	Professional		$37.86	$243.47	$518.75
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.95 / $80.09 / $166.13	Professional	26	$11.95	$80.09	$166.13
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.92 / $169.30 / $352.62	Professional	TC	$25.92	$169.30	$352.62
CareSource Facility/Professional Facility Modifier Low / Median / High Price $25.96 / $64.08 / $108.05	Facility		$25.96	$64.08	$108.05
CareSource Facility/Professional Professional Modifier Low / Median / High Price $25.96 / $64.08 / $108.05	Professional		$25.96	$64.08	$108.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $290.64 / $330.27 / $468.79	Facility		$290.64	$330.27	$468.79
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.30 / $96.93 / $137.58	Facility	26	$85.30	$96.93	$137.58
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $205.34 / $233.34 / $331.21	Facility	TC	$205.34	$233.34	$331.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.02 / $129.15 / $290.31	Professional		$45.02	$129.15	$290.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.98 / $36.81 / $87.85	Professional	26	$12.98	$36.81	$87.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.04 / $92.47 / $202.49	Professional	TC	$32.04	$92.47	$202.49
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $73.09 / $100.16 / $270.12	Facility		$73.09	$100.16	$270.12
Medica Facility/Professional Facility Modifier Low / Median / High Price $73.09 / $108.05 / $280.41	Facility		$73.09	$108.05	$280.41
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $124.11 / $124.11 / $124.11	Facility	26	$124.11	$124.11	$124.11
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $313.37 / $313.37 / $313.37	Facility	TC	$313.37	$313.37	$313.37
Medica Facility/Professional Professional Modifier Low / Median / High Price $60.72 / $135.49 / $559.76	Professional		$60.72	$135.49	$559.76
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $20.21 / $75.90 / $173.52	Professional	26	$20.21	$75.90	$173.52
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $40.45 / $98.08 / $386.24	Professional	TC	$40.45	$98.08	$386.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.04 / $70.00 / $182.59	Professional		$32.04	$70.00	$182.59
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $73.09 / $100.16 / $270.12	Facility		$73.09	$100.16	$270.12
Quartz Facility/Professional Professional Modifier Low / Median / High Price $129.37 / $222.91 / $324.17	Professional		$129.37	$222.91	$324.17
Quartz Facility/Professional Facility Modifier Low / Median / High Price $176.16 / $176.16 / $437.49	Facility		$176.16	$176.16	$437.49
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $71.22 / $71.22 / $124.11	Facility	26	$71.22	$71.22	$124.11
Quartz Facility/Professional Facility Modifier TC Low / Median / High Price $121.70 / $121.70 / $313.37	Facility	TC	$121.70	$121.70	$313.37
Quartz Facility/Professional Professional Modifier Low / Median / High Price $44.66 / $450.95 / $559.76	Professional		$44.66	$450.95	$559.76
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $13.93 / $144.44 / $173.52	Professional	26	$13.93	$144.44	$173.52
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $30.73 / $306.55 / $386.24	Professional	TC	$30.73	$306.55	$386.24
Security Health Facility/Professional Professional Modifier Low / Median / High Price $66.66 / $258.31 / $468.58	Professional		$66.66	$258.31	$468.58
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $21.89 / $21.89 / $104.31	Professional	26	$21.89	$21.89	$104.31
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $44.78 / $44.78 / $178.64	Professional	TC	$44.78	$44.78	$178.64
United Facility/Professional Professional Modifier Low / Median / High Price $60.66 / $90.19 / $291.72	Professional		$60.66	$90.19	$291.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.38 / $28.89 / $83.21	Professional	26	$18.38	$28.89	$83.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $40.01 / $61.30 / $210.02	Professional	TC	$40.01	$61.30	$210.02