Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $159.16 / $159.16 / $306.08	Facility	26	$159.16	$159.16	$306.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $259.41 / $447.81 / $1,262.33	Professional		$259.41	$447.81	$1,262.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.23 / $159.16 / $964.44	Professional	26	$78.23	$159.16	$964.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $151.62 / $207.55 / $446.81	Professional	TC	$151.62	$207.55	$446.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $227.55 / $447.81 / $1,583.84	Professional		$227.55	$447.81	$1,583.84
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $84.86 / $159.16 / $536.39	Professional	26	$84.86	$159.16	$536.39
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $142.69 / $288.66 / $1,054.20	Professional	TC	$142.69	$288.66	$1,054.20
CareSource Facility/Professional Professional Modifier Low / Median / High Price $83.47 / $164.54 / $280.98	Professional		$83.47	$164.54	$280.98
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $216.27 / $252.73 / $387.69	Facility	26	$216.27	$252.73	$387.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $346.01 / $670.46 / $761.89	Professional		$346.01	$670.46	$761.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $115.03 / $236.48 / $268.73	Professional	26	$115.03	$236.48	$268.73
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $198.94 / $433.98 / $493.16	Professional	TC	$198.94	$433.98	$493.16
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $366.35 / $366.35 / $366.35	Facility	26	$366.35	$366.35	$366.35
Medica Facility/Professional Professional Modifier Low / Median / High Price $265.60 / $475.13 / $2,380.40	Professional		$265.60	$475.13	$2,380.40
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $98.04 / $176.28 / $520.19	Professional	26	$98.04	$176.28	$520.19
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $164.75 / $313.55 / $982.86	Professional	TC	$164.75	$313.55	$982.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $80.47 / $197.87 / $438.94	Professional		$80.47	$197.87	$438.94
Quartz Facility/Professional Professional Modifier Low / Median / High Price $429.38 / $544.90 / $849.46	Professional		$429.38	$544.90	$849.46
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $195.88 / $366.35 / $366.35	Facility	26	$195.88	$366.35	$366.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $343.52 / $1,141.30 / $2,380.40	Professional		$343.52	$1,141.30	$2,380.40
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $123.06 / $423.75 / $520.19	Professional	26	$123.06	$423.75	$520.19
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $220.46 / $717.55 / $982.86	Professional	TC	$220.46	$717.55	$982.86
Security Health Facility/Professional Professional Modifier Low / Median / High Price $458.57 / $1,588.48 / $1,588.48	Professional		$458.57	$1,588.48	$1,588.48
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $299.81 / $352.72 / $443.50	Professional	26	$299.81	$352.72	$443.50
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $634.34 / $746.28 / $805.61	Professional	TC	$634.34	$746.28	$805.61
United Facility/Professional Professional Modifier Low / Median / High Price $243.78 / $447.44 / $1,000.35	Professional		$243.78	$447.44	$1,000.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $91.71 / $168.63 / $377.89	Professional	26	$91.71	$168.63	$377.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $164.17 / $302.24 / $684.70	Professional	TC	$164.17	$302.24	$684.70