Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $158.49 / $2,238.72 / $2,238.72	Facility	26	$158.49	$2,238.72	$2,238.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $407.38 / $1,174.90	Professional		$229.09	$407.38	$1,174.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $131.83 / $616.60	Professional	26	$77.62	$131.83	$616.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $177.83 / $316.23	Professional	TC	$138.04	$177.83	$316.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $338.84 / $1,071.52	Professional		$229.09	$338.84	$1,071.52
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $125.89 / $380.19	Professional	26	$83.18	$125.89	$380.19
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $218.78 / $707.95	Professional	TC	$144.54	$218.78	$707.95
CareSource Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $177.83 / $302.00	Professional		$87.10	$177.83	$302.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $213.80 / $251.19 / $407.38	Facility	26	$213.80	$251.19	$407.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $630.96 / $776.25	Professional		$288.40	$630.96	$776.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $223.87 / $275.42	Professional	26	$97.72	$223.87	$275.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $416.87 / $501.19	Professional	TC	$173.78	$416.87	$501.19
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $478.63 / $691.83	Professional		$416.87	$478.63	$691.83
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $147.91 / $169.82 / $245.47	Professional	26	$147.91	$169.82	$245.47
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $309.03 / $446.68	Professional	TC	$269.15	$309.03	$446.68
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $363.08 / $363.08 / $363.08	Facility	26	$363.08	$363.08	$363.08
Medica Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $426.58 / $2,398.83	Professional		$245.47	$426.58	$2,398.83
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $151.36 / $524.81	Professional	26	$89.13	$151.36	$524.81
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $269.15 / $977.24	Professional	TC	$151.36	$269.15	$977.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $263.03	Professional		$32.36	$33.11	$263.03
Quartz Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $549.54 / $812.83	Professional		$302.00	$549.54	$812.83
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $190.55 / $524.81 / $524.81	Facility	26	$190.55	$524.81	$524.81
Quartz Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $1,148.15 / $2,398.83	Professional		$275.42	$1,148.15	$2,398.83
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $426.58 / $524.81	Professional	26	$100.00	$426.58	$524.81
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $724.44 / $977.24	Professional	TC	$177.83	$724.44	$977.24
Security Health Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $1,202.26 / $1,698.24	Professional		$436.52	$1,202.26	$1,698.24
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $302.00 / $354.81 / $446.68	Professional	26	$302.00	$354.81	$446.68
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $602.56 / $741.31 / $812.83	Professional	TC	$602.56	$741.31	$812.83
United Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $346.74 / $870.96	Professional		$239.88	$346.74	$870.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $125.89 / $331.13	Professional	26	$87.10	$125.89	$331.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $223.87 / $562.34	Professional	TC	$151.36	$223.87	$562.34