Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $516.74 / $2,124.80 / $4,382.74	Facility		$516.74	$2,124.80	$4,382.74
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.31 / $152.53 / $713.31	Facility	26	$73.31	$152.53	$713.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $189.40 / $378.80 / $1,530.67	Professional		$189.40	$378.80	$1,530.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.33 / $132.63 / $724.85	Professional	26	$64.33	$132.63	$724.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $116.71 / $238.11 / $666.00	Professional	TC	$116.71	$238.11	$666.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $202.20 / $378.80 / $1,329.20	Professional		$202.20	$378.80	$1,329.20
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $70.98 / $132.63 / $447.74	Professional	26	$70.98	$132.63	$447.74
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $129.24 / $246.16 / $905.55	Professional	TC	$129.24	$246.16	$905.55
CareSource Facility/Professional Facility Modifier Low / Median / High Price $70.28 / $148.58 / $245.97	Facility		$70.28	$148.58	$245.97
CareSource Facility/Professional Professional Modifier Low / Median / High Price $69.70 / $139.82 / $237.18	Professional		$69.70	$139.82	$237.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $535.27 / $625.50 / $959.53	Facility		$535.27	$625.50	$959.53
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $180.22 / $210.61 / $323.08	Facility	26	$180.22	$210.61	$323.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $292.35 / $567.60 / $645.00	Professional		$292.35	$567.60	$645.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.96 / $197.38 / $224.30	Professional	26	$90.96	$197.38	$224.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $189.08 / $370.21 / $420.69	Professional	TC	$189.08	$370.21	$420.69
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $188.75 / $323.14 / $604.28	Facility		$188.75	$323.14	$604.28
Medica Facility/Professional Facility Modifier Low / Median / High Price $206.97 / $604.28 / $2,886.23	Facility		$206.97	$604.28	$2,886.23
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $305.79 / $305.79 / $1,815.00	Facility	26	$305.79	$305.79	$1,815.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $234.76 / $444.20 / $3,949.29	Professional		$234.76	$444.20	$3,949.29
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $75.29 / $145.74 / $433.24	Professional	26	$75.29	$145.74	$433.24
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $148.06 / $300.58 / $1,005.74	Professional	TC	$148.06	$300.58	$1,005.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $61.81 / $137.89 / $315.45	Professional		$61.81	$137.89	$315.45
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $188.75 / $323.14 / $604.28	Facility		$188.75	$323.14	$604.28
Quartz Facility/Professional Professional Modifier Low / Median / High Price $136.22 / $458.29 / $659.78	Professional		$136.22	$458.29	$659.78
Quartz Facility/Professional Facility Modifier Low / Median / High Price $470.15 / $915.00 / $915.00	Facility		$470.15	$915.00	$915.00
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $163.50 / $305.79 / $305.79	Facility	26	$163.50	$305.79	$305.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $301.82 / $1,009.40 / $3,949.29	Professional		$301.82	$1,009.40	$3,949.29
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $96.65 / $364.35 / $433.24	Professional	26	$96.65	$364.35	$433.24
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $198.71 / $651.66 / $1,005.74	Professional	TC	$198.71	$651.66	$1,005.74
Security Health Facility/Professional Professional Modifier Low / Median / High Price $718.54 / $1,344.80 / $1,344.80	Professional		$718.54	$1,344.80	$1,344.80
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $246.08 / $263.37 / $333.24	Professional	26	$246.08	$263.37	$333.24
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $472.46 / $661.31 / $713.88	Professional	TC	$472.46	$661.31	$713.88
United Facility/Professional Professional Modifier Low / Median / High Price $90.00 / $375.51 / $884.74	Professional		$90.00	$375.51	$884.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.06 / $131.54 / $319.35	Professional	26	$75.06	$131.54	$319.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $143.24 / $268.33 / $584.45	Professional	TC	$143.24	$268.33	$584.45