Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $199.53 / $1,000.00	Professional		$120.23	$199.53	$1,000.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $131.83 / $691.83	Professional	26	$33.88	$131.83	$691.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $125.89 / $316.23	Professional	TC	$79.43	$125.89	$316.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $346.74 / $1,023.29	Professional		$70.79	$346.74	$1,023.29
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $109.65 / $239.88	Professional	26	$16.60	$109.65	$239.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $275.42 / $776.25	Professional	TC	$54.95	$275.42	$776.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $154.88 / $218.78	Facility		$43.65	$154.88	$218.78
CareSource Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $138.04 / $269.15	Professional		$35.48	$138.04	$269.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $630.96 / $933.25	Facility		$562.34	$630.96	$933.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $117.49 / $131.83 / $194.98	Facility	26	$117.49	$131.83	$194.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $229.09 / $501.19	Professional		$79.43	$229.09	$501.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $50.12 / $114.82	Professional	26	$18.62	$50.12	$114.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $181.97 / $398.11	Professional	TC	$63.10	$181.97	$398.11
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $194.98 / $501.19	Facility		$141.25	$194.98	$501.19
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $467.74 / $524.81	Professional		$467.74	$467.74	$524.81
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $102.33 / $114.82	Professional	26	$102.33	$102.33	$114.82
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $363.08 / $363.08 / $407.38	Professional	TC	$363.08	$363.08	$407.38
Medica Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $199.53 / $501.19	Facility		$141.25	$199.53	$501.19
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $213.80 / $213.80 / $213.80	Facility	26	$213.80	$213.80	$213.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $165.96 / $1,071.52	Professional		$104.71	$165.96	$1,071.52
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $53.70 / $234.42	Professional	26	$26.92	$53.70	$234.42
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $128.82 / $851.14	Professional	TC	$69.18	$128.82	$851.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $58.88 / $85.11	Professional		$32.36	$58.88	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $407.38 / $602.56	Professional		$223.87	$407.38	$602.56
Quartz Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $524.81 / $1,071.52	Facility		$524.81	$524.81	$1,071.52
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $213.80 / $213.80 / $234.42	Facility	26	$213.80	$213.80	$234.42
Quartz Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $549.54 / $1,071.52	Professional		$79.43	$549.54	$1,071.52
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $128.82 / $234.42	Professional	26	$17.78	$128.82	$234.42
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $426.58 / $851.14	Professional	TC	$63.10	$426.58	$851.14
Security Health Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $416.87 / $891.25	Professional		$125.89	$416.87	$891.25
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $30.20 / $128.82	Professional	26	$30.20	$30.20	$128.82
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $95.50 / $416.87	Professional	TC	$95.50	$95.50	$416.87
United Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $165.96 / $354.81	Professional		$102.33	$165.96	$354.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $38.90 / $112.20	Professional	26	$23.99	$38.90	$112.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $128.82 / $275.42	Professional	TC	$67.61	$128.82	$275.42