Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.10 / $63.10 / $218.78	Facility	26	$63.10	$63.10	$218.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $177.83 / $354.81	Professional		$147.91	$177.83	$354.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $63.10 / $144.54	Professional	26	$52.48	$63.10	$144.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $112.20 / $190.55	Professional	TC	$91.20	$112.20	$190.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $457.09 / $1,318.26	Professional		$302.00	$457.09	$1,318.26
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $87.10 / $234.42	Professional	26	$58.88	$87.10	$234.42
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $371.54 / $1,047.13	Professional	TC	$245.47	$371.54	$1,047.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $154.88 / $181.97 / $288.40	Facility	26	$154.88	$181.97	$288.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $758.58 / $954.99	Professional		$316.23	$758.58	$954.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $144.54 / $177.83	Professional	26	$63.10	$144.54	$177.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $616.60 / $794.33	Professional	TC	$257.04	$616.60	$794.33
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $602.56 / $812.83	Professional		$537.03	$602.56	$812.83
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $120.23 / $162.18	Professional	26	$104.71	$120.23	$162.18
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $426.58 / $489.78 / $660.69	Professional	TC	$426.58	$489.78	$660.69
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $263.03 / $263.03 / $263.03	Facility	26	$263.03	$263.03	$263.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $501.19 / $1,737.80	Professional		$316.23	$501.19	$1,737.80
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $102.33 / $371.54	Professional	26	$61.66	$102.33	$371.54
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $407.38 / $1,412.54	Professional	TC	$257.04	$407.38	$1,412.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $363.08	Professional		$32.36	$33.11	$363.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $724.44 / $1,023.29	Professional		$398.11	$724.44	$1,023.29
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $134.90 / $371.54 / $371.54	Facility	26	$134.90	$371.54	$371.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $831.76 / $1,778.28	Professional		$323.59	$831.76	$1,778.28
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $295.12 / $371.54	Professional	26	$61.66	$295.12	$371.54
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $602.56 / $1,445.44	Professional	TC	$257.04	$602.56	$1,445.44
Security Health Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $851.14 / $1,023.29	Professional		$691.83	$851.14	$1,023.29
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $125.89 / $147.91 / $190.55	Professional	26	$125.89	$147.91	$190.55
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $524.81 / $660.69 / $831.76	Professional	TC	$524.81	$660.69	$831.76
United Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $446.68 / $977.24	Professional		$316.23	$446.68	$977.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $87.10 / $190.55	Professional	26	$61.66	$87.10	$190.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $363.08 / $794.33	Professional	TC	$257.04	$363.08	$794.33