Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $525.08 / $525.08 / $12,480.15	Facility	26	$525.08	$525.08	$12,480.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,012.82 / $1,392.95 / $3,264.09	Professional		$1,012.82	$1,392.95	$3,264.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $284.62 / $663.28 / $3,085.50	Professional	26	$284.62	$663.28	$3,085.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $728.19 / $981.11 / $1,453.39	Professional	TC	$728.19	$981.11	$1,453.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,000.61 / $2,022.98 / $7,090.01	Professional		$1,000.61	$2,022.98	$7,090.01
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $282.39 / $537.35 / $1,922.88	Professional	26	$282.39	$537.35	$1,922.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $718.23 / $1,506.34 / $4,999.06	Professional	TC	$718.23	$1,506.34	$4,999.06
CareSource Facility/Professional Professional Modifier Low / Median / High Price $420.12 / $1,307.51 / $2,021.01	Professional		$420.12	$1,307.51	$2,021.01
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $710.98 / $830.84 / $1,340.12	Facility	26	$710.98	$830.84	$1,340.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,734.95 / $2,911.25 / $4,236.31	Professional		$1,734.95	$2,911.25	$4,236.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $504.66 / $782.79 / $1,131.02	Professional	26	$504.66	$782.79	$1,131.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $1,204.75 / $2,128.46 / $3,105.29	Professional	TC	$1,204.75	$2,128.46	$3,105.29
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,194.47 / $2,136.94 / $5,751.89	Professional		$1,194.47	$2,136.94	$5,751.89
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $337.25 / $637.09 / $1,646.65	Professional	26	$337.25	$637.09	$1,646.65
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $887.55 / $1,554.20 / $4,183.33	Professional	TC	$887.55	$1,554.20	$4,183.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $266.53 / $871.63 / $2,153.44	Professional		$266.53	$871.63	$2,153.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,125.37 / $2,676.92 / $3,608.77	Professional		$2,125.37	$2,676.92	$3,608.77
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $2,654.96 / $2,654.96 / $2,654.96	Facility	26	$2,654.96	$2,654.96	$2,654.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,562.61 / $4,340.57 / $6,888.39	Professional		$1,562.61	$4,340.57	$6,888.39
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $420.17 / $1,167.11 / $1,791.90	Professional	26	$420.17	$1,167.11	$1,791.90
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $1,142.44 / $3,173.45 / $5,096.49	Professional	TC	$1,142.44	$3,173.45	$5,096.49
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,198.00 / $7,154.18 / $7,154.18	Professional		$2,198.00	$7,154.18	$7,154.18
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $627.98 / $1,459.08 / $1,590.20	Professional	26	$627.98	$1,459.08	$1,590.20
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $2,965.14 / $3,488.40 / $4,144.10	Professional	TC	$2,965.14	$3,488.40	$4,144.10
United Facility/Professional Professional Modifier Low / Median / High Price $1,194.47 / $2,178.13 / $5,396.93	Professional		$1,194.47	$2,178.13	$5,396.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $336.21 / $715.22 / $1,471.76	Professional	26	$336.21	$715.22	$1,471.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $770.34 / $1,554.20 / $3,565.03	Professional	TC	$770.34	$1,554.20	$3,565.03