Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $283.68 / $1,446.20 / $2,014.08	Facility		$283.68	$1,446.20	$2,014.08
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.21 / $40.49 / $119.02	Facility	26	$35.21	$40.49	$119.02
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $167.42 / $734.46 / $1,736.60	Facility	TC	$167.42	$734.46	$1,736.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $180.92 / $293.69 / $1,878.68	Professional		$180.92	$293.69	$1,878.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.81 / $54.85 / $276.00	Professional	26	$30.81	$54.85	$276.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $140.97 / $176.35 / $513.95	Professional	TC	$140.97	$176.35	$513.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $187.61 / $331.65 / $1,120.21	Professional		$187.61	$331.65	$1,120.21
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.14 / $57.91 / $203.66	Professional	26	$33.14	$57.91	$203.66
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $151.91 / $273.75 / $924.60	Professional	TC	$151.91	$273.75	$924.60
CareSource Facility/Professional Facility Modifier Low / Median / High Price $33.54 / $165.56 / $239.65	Facility		$33.54	$165.56	$239.65
CareSource Facility/Professional Professional Modifier Low / Median / High Price $32.65 / $163.04 / $223.14	Professional		$32.65	$163.04	$223.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $510.94 / $597.07 / $915.92	Facility		$510.94	$597.07	$915.92
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $84.71 / $98.98 / $151.85	Facility	26	$84.71	$98.98	$151.85
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $426.23 / $498.08 / $764.07	Facility	TC	$426.23	$498.08	$764.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $211.23 / $472.90 / $537.39	Professional		$211.23	$472.90	$537.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.11 / $81.50 / $92.61	Professional	26	$37.11	$81.50	$92.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $171.53 / $391.40 / $444.78	Professional	TC	$171.53	$391.40	$444.78
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $167.67 / $233.41 / $391.74	Facility		$167.67	$233.41	$391.74
Medica Facility/Professional Facility Modifier Low / Median / High Price $168.13 / $302.50 / $1,432.77	Facility		$168.13	$302.50	$1,432.77
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $212.00 / $212.00 / $646.50	Facility	26	$212.00	$212.00	$646.50
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $523.66 / $903.63 / $1,703.70	Facility	TC	$523.66	$903.63	$1,703.70
Medica Facility/Professional Professional Modifier Low / Median / High Price $240.61 / $400.57 / $1,578.90	Professional		$240.61	$400.57	$1,578.90
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $40.03 / $78.37 / $889.65	Professional	26	$40.03	$78.37	$889.65
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $197.93 / $335.98 / $1,388.59	Professional	TC	$197.93	$335.98	$1,388.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $57.73 / $189.55 / $386.94	Professional		$57.73	$189.55	$386.94
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $167.67 / $232.23 / $391.74	Facility		$167.67	$232.23	$391.74
Quartz Facility/Professional Professional Modifier Low / Median / High Price $268.83 / $436.21 / $627.99	Professional		$268.83	$436.21	$627.99
Quartz Facility/Professional Facility Modifier Low / Median / High Price $444.60 / $837.16 / $837.16	Facility		$444.60	$837.16	$837.16
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $212.00 / $212.00	Facility	26	$100.00	$212.00	$212.00
Quartz Facility/Professional Facility Modifier TC Low / Median / High Price $367.98 / $691.80 / $691.80	Facility	TC	$367.98	$691.80	$691.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $213.41 / $940.95 / $1,578.90	Professional		$213.41	$940.95	$1,578.90
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $36.78 / $167.45 / $889.65	Professional	26	$36.78	$167.45	$889.65
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $176.62 / $773.50 / $1,388.59	Professional	TC	$176.62	$773.50	$1,388.59
Security Health Facility/Professional Professional Modifier Low / Median / High Price $354.35 / $955.17 / $955.17	Professional		$354.35	$955.17	$955.17
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $86.03 / $98.43 / $108.85	Professional	26	$86.03	$98.43	$108.85
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $255.92 / $397.59 / $503.07	Professional	TC	$255.92	$397.59	$503.07
United Facility/Professional Professional Modifier Low / Median / High Price $224.05 / $382.24 / $705.71	Professional		$224.05	$382.24	$705.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.14 / $65.09 / $125.59	Professional	26	$37.14	$65.09	$125.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $185.04 / $308.49 / $585.22	Professional	TC	$185.04	$308.49	$585.22