Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $193.20 / $625.10 / $938.56	Facility		$193.20	$625.10	$938.56
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.49 / $39.49 / $136.22	Facility	26	$39.49	$39.49	$136.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $189.19 / $241.61 / $980.00	Professional		$189.19	$241.61	$980.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.25 / $42.17 / $202.49	Professional	26	$34.25	$42.17	$202.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $137.25 / $169.96 / $451.72	Professional	TC	$137.25	$169.96	$451.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.81 / $330.13 / $1,072.92	Professional		$181.81	$330.13	$1,072.92
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $65.29 / $229.80	Professional	26	$37.15	$65.29	$229.80
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $144.65 / $252.37 / $872.11	Professional	TC	$144.65	$252.37	$872.11
CareSource Facility/Professional Facility Modifier Low / Median / High Price $40.01 / $160.35 / $226.00	Facility		$40.01	$160.35	$226.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $37.75 / $151.24 / $217.93	Professional		$37.75	$151.24	$217.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $489.31 / $571.79 / $877.15	Facility		$489.31	$571.79	$877.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $95.52 / $111.62 / $171.23	Facility	26	$95.52	$111.62	$171.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $197.60 / $454.12 / $516.04	Professional		$197.60	$454.12	$516.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.77 / $92.38 / $104.98	Professional	26	$40.77	$92.38	$104.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $161.78 / $361.75 / $411.08	Professional	TC	$161.78	$361.75	$411.08
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $164.62 / $226.04 / $377.21	Facility		$164.62	$226.04	$377.21
Medica Facility/Professional Facility Modifier Low / Median / High Price $164.62 / $238.19 / $522.67	Facility		$164.62	$238.19	$522.67
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $172.60 / $172.60 / $172.60	Facility	26	$172.60	$172.60	$172.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $230.11 / $387.36 / $1,459.71	Professional		$230.11	$387.36	$1,459.71
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $40.42 / $78.63 / $361.59	Professional	26	$40.42	$78.63	$361.59
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $184.98 / $329.07 / $1,274.61	Professional	TC	$184.98	$329.07	$1,274.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $57.73 / $158.14 / $323.97	Professional		$57.73	$158.14	$323.97
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $164.62 / $226.04 / $377.21	Facility		$164.62	$226.04	$377.21
Quartz Facility/Professional Professional Modifier Low / Median / High Price $268.83 / $424.37 / $610.95	Professional		$268.83	$424.37	$610.95
Quartz Facility/Professional Facility Modifier Low / Median / High Price $426.95 / $814.41 / $814.41	Facility		$426.95	$814.41	$814.41
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $172.60 / $172.60	Facility	26	$100.00	$172.60	$172.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $204.93 / $905.95 / $1,459.71	Professional		$204.93	$905.95	$1,459.71
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $188.95 / $361.59	Professional	26	$41.69	$188.95	$361.59
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $163.25 / $716.95 / $1,274.61	Professional	TC	$163.25	$716.95	$1,274.61
Security Health Facility/Professional Professional Modifier Low / Median / High Price $433.09 / $917.23 / $917.23	Professional		$433.09	$917.23	$917.23
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $94.93 / $97.22 / $123.01	Professional	26	$94.93	$97.22	$123.01
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $334.66 / $369.81 / $610.51	Professional	TC	$334.66	$369.81	$610.51
United Facility/Professional Professional Modifier Low / Median / High Price $219.80 / $360.18 / $679.46	Professional		$219.80	$360.18	$679.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.42 / $74.84 / $145.91	Professional	26	$40.42	$74.84	$145.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $177.87 / $298.39 / $537.75	Professional	TC	$177.87	$298.39	$537.75