Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.66 / $120.95 / $671.50	Professional		$89.66	$120.95	$671.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.16 / $62.71 / $671.84	Professional	26	$31.16	$62.71	$671.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $58.04 / $74.76 / $237.76	Professional	TC	$58.04	$74.76	$237.76
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.58 / $346.58 / $701.73	Professional		$54.58	$346.58	$701.73
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $122.75 / $285.93	Professional	26	$20.42	$122.75	$285.93
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $35.86 / $221.91 / $453.76	Professional	TC	$35.86	$221.91	$453.76
CareSource Facility/Professional Facility Modifier Low / Median / High Price $38.13 / $73.16 / $133.55	Facility		$38.13	$73.16	$133.55
CareSource Facility/Professional Professional Modifier Low / Median / High Price $38.13 / $80.48 / $133.55	Professional		$38.13	$80.48	$133.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $385.41 / $437.96 / $621.65	Facility		$385.41	$437.96	$621.65
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $126.36 / $143.60 / $203.82	Facility	26	$126.36	$143.60	$203.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.17 / $162.49 / $385.35	Professional		$59.17	$162.49	$385.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.80 / $56.07 / $130.58	Professional	26	$19.80	$56.07	$130.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.58 / $108.63 / $254.78	Professional	TC	$36.58	$108.63	$254.78
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $100.41 / $137.19 / $333.87	Facility		$100.41	$137.19	$333.87
Medica Facility/Professional Facility Modifier Low / Median / High Price $100.41 / $150.24 / $346.38	Facility		$100.41	$150.24	$346.38
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $221.64 / $221.64 / $221.64	Facility	26	$221.64	$221.64	$221.64
Medica Facility/Professional Professional Modifier Low / Median / High Price $90.19 / $168.37 / $764.45	Professional		$90.19	$168.37	$764.45
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $34.50 / $90.47 / $310.87	Professional	26	$34.50	$90.47	$310.87
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $57.36 / $108.86 / $507.20	Professional	TC	$57.36	$108.86	$507.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.58 / $70.00 / $243.83	Professional		$36.58	$70.00	$243.83
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $100.41 / $137.19 / $333.87	Facility		$100.41	$137.19	$333.87
Quartz Facility/Professional Professional Modifier Low / Median / High Price $100.46 / $275.35 / $400.45	Professional		$100.46	$275.35	$400.45
Quartz Facility/Professional Facility Modifier Low / Median / High Price $231.60 / $231.60 / $540.45	Facility		$231.60	$231.60	$540.45
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $90.87 / $90.87 / $221.64	Facility	26	$90.87	$90.87	$221.64
Quartz Facility/Professional Professional Modifier Low / Median / High Price $63.77 / $610.04 / $764.45	Professional		$63.77	$610.04	$764.45
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $21.35 / $261.91 / $310.87	Professional	26	$21.35	$261.91	$310.87
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $42.42 / $394.45 / $507.20	Professional	TC	$42.42	$394.45	$507.20
Security Health Facility/Professional Professional Modifier Low / Median / High Price $327.16 / $327.16 / $621.95	Professional		$327.16	$327.16	$621.95
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $42.20 / $42.20 / $201.59	Professional	26	$42.20	$42.20	$201.59
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $60.59 / $60.59 / $288.77	Professional	TC	$60.59	$60.59	$288.77
United Facility/Professional Professional Modifier Low / Median / High Price $87.13 / $122.01 / $322.97	Professional		$87.13	$122.01	$322.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $43.12 / $145.44	Professional	26	$30.20	$43.12	$145.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $50.02 / $78.89 / $209.47	Professional	TC	$50.02	$78.89	$209.47