Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $117.76 / $117.76 / $224.68	Facility	26	$117.76	$117.76	$224.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.31 / $138.00 / $430.47	Professional		$97.31	$138.00	$430.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.34 / $80.19 / $268.00	Professional	26	$57.34	$80.19	$268.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $31.87 / $53.86 / $89.07	Professional	TC	$31.87	$53.86	$89.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.95 / $175.80 / $636.21	Professional		$89.95	$175.80	$636.21
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $62.05 / $110.72 / $365.27	Professional	26	$62.05	$110.72	$365.27
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $27.37 / $65.91 / $232.66	Professional	TC	$27.37	$65.91	$232.66
CareSource Facility/Professional Professional Modifier Low / Median / High Price $43.80 / $94.87 / $216.41	Professional		$43.80	$94.87	$216.41
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $157.69 / $184.28 / $282.69	Facility	26	$157.69	$184.28	$282.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $158.53 / $304.17 / $345.65	Professional		$158.53	$304.17	$345.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $92.96 / $173.06 / $196.66	Professional	26	$92.96	$173.06	$196.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $66.87 / $131.08 / $148.94	Professional	TC	$66.87	$131.08	$148.94
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $140.60 / $284.70 / $284.70	Facility	26	$140.60	$284.70	$284.70
Medica Facility/Professional Professional Modifier Low / Median / High Price $101.41 / $169.52 / $865.60	Professional		$101.41	$169.52	$865.60
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $66.69 / $117.80 / $382.35	Professional	26	$66.69	$117.80	$382.35
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $35.04 / $53.50 / $307.58	Professional	TC	$35.04	$53.50	$307.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.07 / $63.07 / $188.51	Professional		$25.07	$63.07	$188.51
Quartz Facility/Professional Professional Modifier Low / Median / High Price $187.20 / $246.11 / $343.20	Professional		$187.20	$246.11	$343.20
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $80.12 / $140.60 / $284.70	Facility	26	$80.12	$140.60	$284.70
Quartz Facility/Professional Professional Modifier Low / Median / High Price $176.36 / $485.90 / $865.60	Professional		$176.36	$485.90	$865.60
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $100.35 / $314.10 / $382.35	Professional	26	$100.35	$314.10	$382.35
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $70.36 / $195.44 / $307.58	Professional	TC	$70.36	$195.44	$307.58
Security Health Facility/Professional Professional Modifier Low / Median / High Price $332.49 / $492.25 / $720.64	Professional		$332.49	$492.25	$720.64
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $221.15 / $260.18 / $320.01	Professional	26	$221.15	$260.18	$320.01
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $92.86 / $109.25 / $213.89	Professional	TC	$92.86	$109.25	$213.89
United Facility/Professional Professional Modifier Low / Median / High Price $101.41 / $164.10 / $353.00	Professional		$101.41	$164.10	$353.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.95 / $111.41 / $235.58	Professional	26	$64.95	$111.41	$235.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.53 / $56.69 / $114.58	Professional	TC	$35.53	$56.69	$114.58