Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $189.62 / $291.17 / $710.82	Professional		$189.62	$291.17	$710.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.09 / $58.98 / $96.87	Professional	26	$47.09	$58.98	$96.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $133.25 / $242.94 / $613.94	Professional	TC	$133.25	$242.94	$613.94
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $167.04 / $1,060.70 / $2,257.23	Professional		$167.04	$1,060.70	$2,257.23
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.78 / $187.04 / $380.50	Professional	26	$26.78	$187.04	$380.50
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $140.26 / $741.98 / $1,876.74	Professional	TC	$140.26	$741.98	$1,876.74
CareSource Facility/Professional Professional Modifier Low / Median / High Price $59.63 / $301.52 / $433.38	Professional		$59.63	$301.52	$433.38
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $194.81 / $221.38 / $314.22	Facility	26	$194.81	$221.38	$314.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $180.58 / $481.76 / $1,261.15	Professional		$180.58	$481.76	$1,261.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.74 / $86.38 / $202.10	Professional	26	$30.74	$86.38	$202.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $145.26 / $437.30 / $1,059.06	Professional	TC	$145.26	$437.30	$1,059.06
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $283.08 / $283.08 / $283.08	Facility	26	$283.08	$283.08	$283.08
Medica Facility/Professional Professional Modifier Low / Median / High Price $193.89 / $392.45 / $2,575.76	Professional		$193.89	$392.45	$2,575.76
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $45.02 / $72.63 / $393.91	Professional	26	$45.02	$72.63	$393.91
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $132.11 / $326.27 / $2,181.85	Professional	TC	$132.11	$326.27	$2,181.85
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,015.13	Professional		$50.00	$70.00	$1,015.13
Quartz Facility/Professional Professional Modifier Low / Median / High Price $409.33 / $897.02 / $1,304.54	Professional		$409.33	$897.02	$1,304.54
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $243.03 / $243.03 / $283.08	Facility	26	$243.03	$243.03	$283.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $200.98 / $1,962.25 / $2,575.76	Professional		$200.98	$1,962.25	$2,575.76
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $31.60 / $330.85 / $393.91	Professional	26	$31.60	$330.85	$393.91
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $159.13 / $1,631.40 / $2,181.85	Professional	TC	$159.13	$1,631.40	$2,181.85
Security Health Facility/Professional Professional Modifier Low / Median / High Price $295.24 / $295.24 / $2,035.49	Professional		$295.24	$295.24	$2,035.49
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $49.25 / $49.25 / $190.98	Professional	26	$49.25	$49.25	$190.98
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $245.99 / $245.99 / $984.51	Professional	TC	$245.99	$245.99	$984.51
United Facility/Professional Professional Modifier Low / Median / High Price $196.94 / $377.49 / $1,130.26	Professional		$196.94	$377.49	$1,130.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.02 / $66.17 / $190.57	Professional	26	$45.02	$66.17	$190.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $135.40 / $311.93 / $939.69	Professional	TC	$135.40	$311.93	$939.69