Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.56 / $161.71 / $641.75	Professional		$103.56	$161.71	$641.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.79 / $44.19 / $296.38	Professional	26	$28.79	$44.19	$296.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $68.95 / $126.37 / $279.13	Professional	TC	$68.95	$126.37	$279.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.42 / $458.62 / $962.90	Professional		$71.42	$458.62	$962.90
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.42 / $111.54 / $225.46	Professional	26	$16.42	$111.54	$225.46
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $55.01 / $349.31 / $737.43	Professional	TC	$55.01	$349.31	$737.43
CareSource Facility/Professional Facility Modifier Low / Median / High Price $35.54 / $125.17 / $192.85	Facility		$35.54	$125.17	$192.85
CareSource Facility/Professional Professional Modifier Low / Median / High Price $35.54 / $125.17 / $192.85	Professional		$35.54	$125.17	$192.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $556.00 / $631.82 / $896.81	Facility		$556.00	$631.82	$896.81
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $116.89 / $132.83 / $188.53	Facility	26	$116.89	$132.83	$188.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $80.34 / $231.29 / $552.48	Professional		$80.34	$231.29	$552.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.48 / $51.74 / $120.63	Professional	26	$18.48	$51.74	$120.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $62.58 / $181.36 / $425.69	Professional	TC	$62.58	$181.36	$425.69
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $141.63 / $194.59 / $482.13	Facility		$141.63	$194.59	$482.13
Medica Facility/Professional Facility Modifier Low / Median / High Price $141.63 / $194.59 / $501.66	Facility		$141.63	$194.59	$501.66
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $213.67 / $213.67 / $213.67	Facility	26	$213.67	$213.67	$213.67
Medica Facility/Professional Professional Modifier Low / Median / High Price $105.17 / $167.41 / $1,081.50	Professional		$105.17	$167.41	$1,081.50
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $28.70 / $54.11 / $235.79	Professional	26	$28.70	$54.11	$235.79
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $68.45 / $128.19 / $845.71	Professional	TC	$68.45	$128.19	$845.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $398.86	Professional		$50.00	$70.00	$398.86
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $141.63 / $194.59 / $482.13	Facility		$141.63	$194.59	$482.13
Quartz Facility/Professional Professional Modifier Low / Median / High Price $223.83 / $398.76 / $579.91	Professional		$223.83	$398.76	$579.91
Quartz Facility/Professional Facility Modifier Low / Median / High Price $528.48 / $528.48 / $782.64	Facility		$528.48	$528.48	$782.64
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $213.67 / $213.67 / $213.67	Facility	26	$213.67	$213.67	$213.67
Quartz Facility/Professional Professional Modifier Low / Median / High Price $84.53 / $837.05 / $1,081.50	Professional		$84.53	$837.05	$1,081.50
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $18.73 / $196.05 / $235.79	Professional	26	$18.73	$196.05	$235.79
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $65.79 / $641.04 / $845.71	Professional	TC	$65.79	$641.04	$845.71
Security Health Facility/Professional Professional Modifier Low / Median / High Price $125.83 / $125.83 / $891.67	Professional		$125.83	$125.83	$891.67
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $29.98 / $29.98 / $124.91	Professional	26	$29.98	$29.98	$124.91
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $95.85 / $95.85 / $411.37	Professional	TC	$95.85	$95.85	$411.37
United Facility/Professional Professional Modifier Low / Median / High Price $105.17 / $167.41 / $482.14	Professional		$105.17	$167.41	$482.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.49 / $39.21 / $112.92	Professional	26	$26.49	$39.21	$112.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $68.45 / $128.19 / $369.22	Professional	TC	$68.45	$128.19	$369.22