Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.58 / $118.58 / $227.45	Facility	26	$118.58	$118.58	$227.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $224.04 / $425.26 / $1,355.00	Professional		$224.04	$425.26	$1,355.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.42 / $231.71 / $722.50	Professional	26	$66.42	$231.71	$722.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $157.31 / $213.26 / $609.20	Professional	TC	$157.31	$213.26	$609.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $229.83 / $425.26 / $1,437.85	Professional		$229.83	$425.26	$1,437.85
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $63.11 / $118.58 / $399.61	Professional	26	$63.11	$118.58	$399.61
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $166.49 / $306.68 / $1,038.24	Professional	TC	$166.49	$306.68	$1,038.24
CareSource Facility/Professional Professional Modifier Low / Median / High Price $62.04 / $165.91 / $262.02	Professional		$62.04	$165.91	$262.02
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $160.40 / $187.44 / $287.54	Facility	26	$160.40	$187.44	$287.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $284.36 / $633.88 / $720.31	Professional		$284.36	$633.88	$720.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.15 / $176.18 / $200.20	Professional	26	$82.15	$176.18	$200.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $201.84 / $457.71 / $520.13	Professional	TC	$201.84	$457.71	$520.13
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $314.00 / $314.00 / $314.00	Facility	26	$314.00	$314.00	$314.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $238.12 / $470.43 / $1,442.20	Professional		$238.12	$470.43	$1,442.20
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $71.12 / $134.85 / $507.29	Professional	26	$71.12	$134.85	$507.29
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $173.20 / $341.76 / $1,055.58	Professional	TC	$173.20	$341.76	$1,055.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.14 / $190.67 / $392.96	Professional		$58.14	$190.67	$392.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $402.54 / $614.04 / $875.30	Professional		$402.54	$614.04	$875.30
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $145.93 / $314.00 / $314.00	Facility	26	$145.93	$314.00	$314.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $340.23 / $1,130.84 / $1,442.20	Professional		$340.23	$1,130.84	$1,442.20
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $94.56 / $316.25 / $507.29	Professional	26	$94.56	$316.25	$507.29
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $245.67 / $814.60 / $1,055.58	Professional	TC	$245.67	$814.60	$1,055.58
Security Health Facility/Professional Professional Modifier Low / Median / High Price $573.21 / $1,501.83 / $1,501.83	Professional		$573.21	$1,501.83	$1,501.83
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $223.86 / $263.37 / $331.02	Professional	26	$223.86	$263.37	$331.02
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $344.51 / $695.60 / $863.89	Professional	TC	$344.51	$695.60	$863.89
United Facility/Professional Professional Modifier Low / Median / High Price $237.47 / $426.83 / $991.19	Professional		$237.47	$426.83	$991.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $68.41 / $121.96 / $281.54	Professional	26	$68.41	$121.96	$281.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $172.15 / $325.83 / $728.15	Professional	TC	$172.15	$325.83	$728.15