Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $143.58 / $193.98 / $357.59	Professional		$143.58	$193.98	$357.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.51 / $27.47 / $48.12	Professional	26	$17.51	$27.47	$48.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $126.07 / $172.12 / $279.85	Professional	TC	$126.07	$172.12	$279.85
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.54 / $410.47 / $980.86	Professional		$64.54	$410.47	$980.86
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.29 / $87.40 / $152.22	Professional	26	$20.29	$87.40	$152.22
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $44.25 / $343.61 / $853.03	Professional	TC	$44.25	$343.61	$853.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $21.58 / $158.61 / $216.24	Professional		$21.58	$158.61	$216.24
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.55 / $80.17 / $113.80	Facility	26	$70.55	$80.17	$113.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $90.10 / $262.24 / $598.29	Professional		$90.10	$262.24	$598.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.27 / $37.08 / $73.91	Professional	26	$11.27	$37.08	$73.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $79.31 / $235.66 / $527.55	Professional	TC	$79.31	$235.66	$527.55
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $240.51 / $240.51 / $240.51	Facility	26	$240.51	$240.51	$240.51
Medica Facility/Professional Professional Modifier Low / Median / High Price $132.12 / $188.46 / $1,336.58	Professional		$132.12	$188.46	$1,336.58
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $18.50 / $50.18 / $315.72	Professional	26	$18.50	$50.18	$315.72
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $103.47 / $158.62 / $1,188.97	Professional	TC	$103.47	$158.62	$1,188.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $538.33	Professional		$50.00	$70.00	$538.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $298.45 / $448.91 / $630.69	Professional		$298.45	$448.91	$630.69
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $90.94 / $90.94 / $240.51	Facility	26	$90.94	$90.94	$240.51
Quartz Facility/Professional Professional Modifier Low / Median / High Price $96.44 / $938.49 / $1,336.58	Professional		$96.44	$938.49	$1,336.58
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $12.09 / $276.50 / $315.72	Professional	26	$12.09	$276.50	$315.72
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $84.96 / $741.50 / $1,188.97	Professional	TC	$84.96	$741.50	$1,188.97
Security Health Facility/Professional Professional Modifier Low / Median / High Price $88.49 / $308.58 / $1,031.89	Professional		$88.49	$308.58	$1,031.89
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.28 / $19.28 / $91.87	Professional	26	$19.28	$19.28	$91.87
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $69.20 / $69.20 / $329.83	Professional	TC	$69.20	$69.20	$329.83
United Facility/Professional Professional Modifier Low / Median / High Price $105.05 / $173.71 / $531.60	Professional		$105.05	$173.71	$531.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.06 / $80.00 / $119.43	Professional	26	$24.06	$80.00	$119.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $97.49 / $148.30 / $423.30	Professional	TC	$97.49	$148.30	$423.30