Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.40 / $146.15 / $329.44	Professional		$89.40	$146.15	$329.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.02 / $35.13 / $193.90	Professional	26	$27.02	$35.13	$193.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.27 / $84.00 / $184.56	Professional	TC	$54.27	$84.00	$184.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.39 / $306.27 / $706.49	Professional		$41.39	$306.27	$706.49
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.48 / $105.50 / $224.87	Professional	26	$16.48	$105.50	$224.87
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.92 / $195.62 / $530.20	Professional	TC	$24.92	$195.62	$530.20
CareSource Facility/Professional Professional Modifier Low / Median / High Price $33.02 / $101.44 / $161.35	Professional		$33.02	$101.44	$161.35
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $109.52 / $124.45 / $176.64	Facility	26	$109.52	$124.45	$176.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.23 / $182.38 / $453.18	Professional		$67.23	$182.38	$453.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.18 / $48.04 / $113.08	Professional	26	$17.18	$48.04	$113.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.89 / $147.84 / $346.51	Professional	TC	$38.89	$147.84	$346.51
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $173.52 / $173.52 / $173.52	Facility	26	$173.52	$173.52	$173.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $88.91 / $148.84 / $973.09	Professional		$88.91	$148.84	$973.09
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $26.81 / $50.72 / $236.03	Professional	26	$26.81	$50.72	$236.03
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $56.48 / $101.44 / $750.23	Professional	TC	$56.48	$101.44	$750.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $67.23 / $312.47	Professional		$50.00	$67.23	$312.47
Quartz Facility/Professional Professional Modifier Low / Median / High Price $87.89 / $333.41 / $468.42	Professional		$87.89	$333.41	$468.42
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $173.52	Facility	26	$100.00	$100.00	$173.52
Quartz Facility/Professional Professional Modifier Low / Median / High Price $71.89 / $614.20 / $973.09	Professional		$71.89	$614.20	$973.09
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $18.50 / $206.80 / $236.03	Professional	26	$18.50	$206.80	$236.03
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $51.78 / $439.24 / $750.23	Professional	TC	$51.78	$439.24	$750.23
Security Health Facility/Professional Professional Modifier Low / Median / High Price $92.70 / $92.70 / $772.26	Professional		$92.70	$92.70	$772.26
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $28.02 / $28.02 / $143.99	Professional	26	$28.02	$28.02	$143.99
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $41.30 / $41.30 / $196.80	Professional	TC	$41.30	$41.30	$196.80
United Facility/Professional Professional Modifier Low / Median / High Price $75.27 / $122.84 / $399.23	Professional		$75.27	$122.84	$399.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.81 / $36.75 / $118.60	Professional	26	$26.81	$36.75	$118.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $49.86 / $82.32 / $205.36	Professional	TC	$49.86	$82.32	$205.36