Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.95 / $111.83 / $937.44	Professional		$63.95	$111.83	$937.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.21 / $26.69 / $548.08	Professional	26	$21.21	$26.69	$548.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $39.25 / $62.62 / $155.27	Professional	TC	$39.25	$62.62	$155.27
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.52 / $231.73 / $536.26	Professional		$29.52	$231.73	$536.26
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.10 / $85.03 / $170.38	Professional	26	$12.10	$85.03	$170.38
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.48 / $156.18 / $402.76	Professional	TC	$17.48	$156.18	$402.76
CareSource Facility/Professional Professional Modifier Low / Median / High Price $26.62 / $76.26 / $123.46	Professional		$26.62	$76.26	$123.46
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $88.45 / $100.52 / $142.66	Facility	26	$88.45	$100.52	$142.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.44 / $147.88 / $346.95	Professional		$51.44	$147.88	$346.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.76 / $38.79 / $91.18	Professional	26	$13.76	$38.79	$91.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.13 / $110.77 / $260.95	Professional	TC	$38.13	$110.77	$260.95
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $127.16 / $127.16 / $127.16	Facility	26	$127.16	$127.16	$127.16
Medica Facility/Professional Professional Modifier Low / Median / High Price $64.98 / $102.88 / $750.04	Professional		$64.98	$102.88	$750.04
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $20.09 / $32.83 / $179.95	Professional	26	$20.09	$32.83	$179.95
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $38.32 / $69.09 / $570.15	Professional	TC	$38.32	$69.09	$570.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.13 / $70.00 / $219.22	Professional		$38.13	$70.00	$219.22
Quartz Facility/Professional Professional Modifier Low / Median / High Price $138.27 / $255.30 / $358.08	Professional		$138.27	$255.30	$358.08
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $63.39 / $63.39 / $127.16	Facility	26	$63.39	$63.39	$127.16
Quartz Facility/Professional Professional Modifier Low / Median / High Price $54.69 / $450.10 / $750.04	Professional		$54.69	$450.10	$750.04
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $14.29 / $148.15 / $179.95	Professional	26	$14.29	$148.15	$179.95
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $40.99 / $327.92 / $570.15	Professional	TC	$40.99	$327.92	$570.15
Security Health Facility/Professional Professional Modifier Low / Median / High Price $53.83 / $53.83 / $587.44	Professional		$53.83	$53.83	$587.44
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $22.18 / $22.18 / $86.00	Professional	26	$22.18	$22.18	$86.00
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $31.65 / $31.65 / $150.83	Professional	TC	$31.65	$31.65	$150.83
United Facility/Professional Professional Modifier Low / Median / High Price $54.59 / $90.02 / $259.26	Professional		$54.59	$90.02	$259.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.69 / $29.30 / $84.39	Professional	26	$21.69	$29.30	$84.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.28 / $60.39 / $138.90	Professional	TC	$38.28	$60.39	$138.90