Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.57 / $132.77 / $432.29	Professional		$85.57	$132.77	$432.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.26 / $47.18 / $59.72	Professional	26	$32.26	$47.18	$59.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $53.30 / $85.57 / $102.78	Professional	TC	$53.30	$85.57	$102.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.59 / $367.81 / $836.46	Professional		$60.59	$367.81	$836.46
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.33 / $133.03 / $308.48	Professional	26	$22.33	$133.03	$308.48
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $39.46 / $234.78 / $528.00	Professional	TC	$39.46	$234.78	$528.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $75.37 / $130.00	Professional		$39.81	$75.37	$130.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $132.68 / $150.77 / $214.01	Facility	26	$132.68	$150.77	$214.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.49 / $158.00 / $382.66	Professional		$57.49	$158.00	$382.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.60 / $57.74 / $137.40	Professional	26	$20.60	$57.74	$137.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.89 / $104.86 / $245.25	Professional	TC	$36.89	$104.86	$245.25
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $237.42 / $237.42 / $237.42	Facility	26	$237.42	$237.42	$237.42
Medica Facility/Professional Professional Modifier Low / Median / High Price $98.74 / $171.00 / $881.27	Professional		$98.74	$171.00	$881.27
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $35.64 / $73.12 / $342.38	Professional	26	$35.64	$73.12	$342.38
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $62.57 / $107.93 / $549.40	Professional	TC	$62.57	$107.93	$549.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.26 / $70.00 / $233.48	Professional		$34.26	$70.00	$233.48
Quartz Facility/Professional Professional Modifier Low / Median / High Price $208.20 / $273.70 / $394.05	Professional		$208.20	$273.70	$394.05
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $97.15 / $97.15 / $237.42	Facility	26	$97.15	$97.15	$237.42
Quartz Facility/Professional Professional Modifier Low / Median / High Price $63.54 / $704.22 / $881.27	Professional		$63.54	$704.22	$881.27
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $277.25 / $342.38	Professional	26	$22.39	$277.25	$342.38
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $41.15 / $426.97 / $549.40	Professional	TC	$41.15	$426.97	$549.40
Security Health Facility/Professional Professional Modifier Low / Median / High Price $244.90 / $269.47 / $617.58	Professional		$244.90	$269.47	$617.58
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $91.10 / $91.10 / $213.22	Professional	26	$91.10	$91.10	$213.22
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $68.56 / $68.56 / $326.80	Professional	TC	$68.56	$68.56	$326.80
United Facility/Professional Professional Modifier Low / Median / High Price $91.14 / $123.91 / $414.48	Professional		$91.14	$123.91	$414.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.64 / $53.73 / $153.05	Professional	26	$35.64	$53.73	$153.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $62.57 / $79.23 / $254.18	Professional	TC	$62.57	$79.23	$254.18