Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $269.15 / $724.44	Professional		$85.11	$269.15	$724.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $85.11 / $398.11	Professional	26	$30.20	$85.11	$398.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $93.33 / $512.86	Professional	TC	$54.95	$93.33	$512.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $208.93 / $630.96	Professional		$44.67	$208.93	$630.96
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $100.00 / $218.78	Professional	26	$16.22	$100.00	$218.78
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $144.54 / $407.38	Professional	TC	$29.51	$144.54	$407.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $91.20 / $141.25	Facility		$39.81	$91.20	$141.25
CareSource Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $79.43 / $165.96	Professional		$32.36	$79.43	$165.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $389.05 / $562.34	Facility		$338.84	$389.05	$562.34
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $107.15 / $120.23 / $177.83	Facility	26	$107.15	$120.23	$177.83
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $234.42 / $263.03 / $389.05	Facility	TC	$234.42	$263.03	$389.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $154.88 / $338.84	Professional		$50.12	$154.88	$338.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $46.77 / $102.33	Professional	26	$16.60	$46.77	$102.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $104.71 / $213.80	Professional	TC	$26.92	$104.71	$213.80
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $125.89 / $323.59	Facility		$74.13	$125.89	$323.59
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $302.00 / $338.84	Professional		$302.00	$302.00	$338.84
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $93.33 / $102.33	Professional	26	$93.33	$93.33	$102.33
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $213.80 / $234.42	Professional	TC	$213.80	$213.80	$234.42
Medica Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $125.89 / $316.23	Facility		$74.13	$125.89	$316.23
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $169.82 / $169.82 / $169.82	Facility	26	$169.82	$169.82	$169.82
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $354.81 / $354.81 / $354.81	Facility	TC	$354.81	$354.81	$354.81
Medica Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $177.83 / $660.69	Professional		$81.28	$177.83	$660.69
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $117.49 / $275.42	Professional	26	$35.48	$117.49	$275.42
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $128.82 / $426.58	Professional	TC	$51.29	$128.82	$426.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $61.66 / $85.11	Professional		$32.36	$61.66	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $263.03 / $380.19	Professional		$87.10	$263.03	$380.19
Quartz Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $208.93 / $645.65	Facility		$208.93	$208.93	$645.65
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $213.80	Facility	26	$100.00	$100.00	$213.80
Quartz Facility/Professional Facility Modifier TC Low / Median / High Price $144.54 / $144.54 / $436.52	Facility	TC	$144.54	$144.54	$436.52
Quartz Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $512.86 / $660.69	Professional		$50.12	$512.86	$660.69
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $204.17 / $275.42	Professional	26	$15.85	$204.17	$275.42
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $331.13 / $426.58	Professional	TC	$33.11	$331.13	$426.58
Security Health Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $107.15 / $549.54	Professional		$91.20	$107.15	$549.54
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $34.67 / $128.82	Professional	26	$34.67	$34.67	$128.82
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $52.48 / $239.88	Professional	TC	$52.48	$52.48	$239.88
United Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $102.33 / $251.19	Professional		$64.57	$102.33	$251.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $36.31 / $109.65	Professional	26	$22.91	$36.31	$109.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $66.07 / $162.18	Professional	TC	$40.74	$66.07	$162.18