Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.57 / $40.57 / $138.63	Facility	26	$40.57	$40.57	$138.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $180.81 / $285.75 / $1,197.00	Professional		$180.81	$285.75	$1,197.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.31 / $52.45 / $297.50	Professional	26	$34.31	$52.45	$297.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $145.59 / $183.45 / $532.00	Professional	TC	$145.59	$183.45	$532.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $193.35 / $337.50 / $1,172.71	Professional		$193.35	$337.50	$1,172.71
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.18 / $66.69 / $236.02	Professional	26	$38.18	$66.69	$236.02
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $156.22 / $270.81 / $936.69	Professional	TC	$156.22	$270.81	$936.69
CareSource Facility/Professional Professional Modifier Low / Median / High Price $38.03 / $160.54 / $227.16	Professional		$38.03	$160.54	$227.16
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.32 / $113.73 / $174.46	Facility	26	$97.32	$113.73	$174.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $214.35 / $480.35 / $545.85	Professional		$214.35	$480.35	$545.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.29 / $94.05 / $106.88	Professional	26	$40.29	$94.05	$106.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $176.13 / $386.32 / $439.00	Professional	TC	$176.13	$386.32	$439.00
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $210.00 / $210.00 / $668.00	Facility	26	$210.00	$210.00	$668.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $249.41 / $410.73 / $1,582.03	Professional		$249.41	$410.73	$1,582.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $40.78 / $81.56 / $422.69	Professional	26	$40.78	$81.56	$422.69
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $200.21 / $349.39 / $1,414.75	Professional	TC	$200.21	$349.39	$1,414.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $57.73 / $187.12 / $388.88	Professional		$57.73	$187.12	$388.88
Quartz Facility/Professional Professional Modifier Low / Median / High Price $350.74 / $445.10 / $638.21	Professional		$350.74	$445.10	$638.21
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $210.00 / $210.00	Facility	26	$100.00	$210.00	$210.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $216.77 / $964.15 / $1,582.03	Professional		$216.77	$964.15	$1,582.03
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $42.44 / $194.10 / $422.69	Professional	26	$42.44	$194.10	$422.69
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $174.33 / $770.05 / $1,414.75	Professional	TC	$174.33	$770.05	$1,414.75
Security Health Facility/Professional Professional Modifier Low / Median / High Price $413.41 / $970.19 / $970.19	Professional		$413.41	$970.19	$970.19
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $86.91 / $99.00 / $125.26	Professional	26	$86.91	$99.00	$125.26
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $314.98 / $397.59 / $640.91	Professional	TC	$314.98	$397.59	$640.91
United Facility/Professional Professional Modifier Low / Median / High Price $234.08 / $386.76 / $723.11	Professional		$234.08	$386.76	$723.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.75 / $77.86 / $144.22	Professional	26	$39.75	$77.86	$144.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $186.65 / $331.52 / $593.66	Professional	TC	$186.65	$331.52	$593.66