Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.31 / $132.63 / $255.64	Facility	26	$73.31	$132.63	$255.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.54 / $320.80 / $994.00	Professional		$190.54	$320.80	$994.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.28 / $132.63 / $395.68	Professional	26	$74.28	$132.63	$395.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $121.37 / $179.08 / $387.12	Professional	TC	$121.37	$179.08	$387.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $184.08 / $359.06 / $1,322.70	Professional		$184.08	$359.06	$1,322.70
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $69.90 / $132.63 / $447.74	Professional	26	$69.90	$132.63	$447.74
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $113.25 / $226.42 / $835.46	Professional	TC	$113.25	$226.42	$835.46
CareSource Facility/Professional Professional Modifier Low / Median / High Price $69.70 / $127.26 / $223.60	Professional		$69.70	$127.26	$223.60
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 $236.57 / $536.48 / $609.64	Professional		$236.57	$536.48	$609.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $91.73 / $197.38 / $224.30	Professional	26	$91.73	$197.38	$224.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $150.07 / $339.10 / $385.34	Professional	TC	$150.07	$339.10	$385.34
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $557.91 / $557.91 / $557.91	Facility	26	$557.91	$557.91	$557.91
Medica Facility/Professional Professional Modifier Low / Median / High Price $211.11 / $422.79 / $1,677.02	Professional		$211.11	$422.79	$1,677.02
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $81.89 / $150.82 / $718.23	Professional	26	$81.89	$150.82	$718.23
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $121.46 / $275.61 / $985.97	Professional	TC	$121.46	$275.61	$985.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.67 / $132.74 / $312.33	Professional		$55.67	$132.74	$312.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $341.38 / $520.74 / $948.81	Professional		$341.38	$520.74	$948.81
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $163.50 / $557.91 / $557.91	Facility	26	$163.50	$557.91	$557.91
Quartz Facility/Professional Professional Modifier Low / Median / High Price $287.95 / $923.40 / $1,677.02	Professional		$287.95	$923.40	$1,677.02
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $105.94 / $353.70 / $718.23	Professional	26	$105.94	$353.70	$718.23
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $182.01 / $569.70 / $985.97	Professional	TC	$182.01	$569.70	$985.97
Security Health Facility/Professional Professional Modifier Low / Median / High Price $713.62 / $1,271.08 / $1,271.08	Professional		$713.62	$1,271.08	$1,271.08
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $294.42 / $359.89 / $372.53	Professional	26	$294.42	$359.89	$372.53
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $349.43 / $680.09 / $735.47	Professional	TC	$349.43	$680.09	$735.47
United Facility/Professional Professional Modifier Low / Median / High Price $203.64 / $403.50 / $852.52	Professional		$203.64	$403.50	$852.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $78.67 / $127.33 / $314.93	Professional	26	$78.67	$127.33	$314.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $121.46 / $237.00 / $499.34	Professional	TC	$121.46	$237.00	$499.34