Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $126.06 / $421.86 / $640.20	Facility		$126.06	$421.86	$640.20
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.50 / $24.50 / $84.37	Facility	26	$24.50	$24.50	$84.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $110.71 / $132.24 / $451.33	Professional		$110.71	$132.24	$451.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.01 / $24.50 / $126.19	Professional	26	$22.01	$24.50	$126.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $89.48 / $106.95 / $289.20	Professional	TC	$89.48	$106.95	$289.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $116.50 / $206.52 / $706.94	Professional		$116.50	$206.52	$706.94
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.06 / $40.35 / $143.11	Professional	26	$23.06	$40.35	$143.11
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $92.90 / $166.15 / $563.83	Professional	TC	$92.90	$166.15	$563.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $319.89 / $373.83 / $573.46	Facility		$319.89	$373.83	$573.46
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.47 / $69.50 / $106.61	Facility	26	$59.47	$69.50	$106.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.18 / $297.33 / $337.89	Professional		$134.18	$297.33	$337.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.25 / $57.86 / $65.75	Professional	26	$25.25	$57.86	$65.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $108.07 / $239.46 / $272.11	Professional	TC	$108.07	$239.46	$272.11
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $109.16 / $147.49 / $244.39	Facility		$109.16	$147.49	$244.39
Medica Facility/Professional Facility Modifier Low / Median / High Price $107.31 / $156.19 / $271.91	Facility		$107.31	$156.19	$271.91
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $104.46 / $104.46 / $104.46	Facility	26	$104.46	$104.46	$104.46
Medica Facility/Professional Professional Modifier Low / Median / High Price $151.11 / $254.85 / $1,013.21	Professional		$151.11	$254.85	$1,013.21
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $25.92 / $48.98 / $217.94	Professional	26	$25.92	$48.98	$217.94
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $120.51 / $215.53 / $889.85	Professional	TC	$120.51	$215.53	$889.85
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.31 / $125.92 / $253.98	Professional		$55.31	$125.92	$253.98
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $107.89 / $147.49 / $244.39	Facility		$107.89	$147.49	$244.39
Quartz Facility/Professional Professional Modifier Low / Median / High Price $134.44 / $275.29 / $396.32	Professional		$134.44	$275.29	$396.32
Quartz Facility/Professional Facility Modifier Low / Median / High Price $279.55 / $528.33 / $528.33	Facility		$279.55	$528.33	$528.33
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $104.46 / $104.46	Facility	26	$100.00	$104.46	$104.46
Quartz Facility/Professional Professional Modifier Low / Median / High Price $134.18 / $581.20 / $1,013.21	Professional		$134.18	$581.20	$1,013.21
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $26.12 / $117.70 / $217.94	Professional	26	$26.12	$117.70	$217.94
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $108.07 / $463.50 / $889.85	Professional	TC	$108.07	$463.50	$889.85
Security Health Facility/Professional Professional Modifier Low / Median / High Price $249.17 / $600.54 / $600.54	Professional		$249.17	$600.54	$600.54
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $49.22 / $60.92 / $77.08	Professional	26	$49.22	$60.92	$77.08
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $232.22 / $255.92 / $425.11	Professional	TC	$232.22	$255.92	$425.11
United Facility/Professional Facility Modifier Low / Median / High Price $176.68 / $176.68 / $176.68	Facility		$176.68	$176.68	$176.68
United Facility/Professional Professional Modifier Low / Median / High Price $137.87 / $235.68 / $435.90	Professional		$137.87	$235.68	$435.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.92 / $46.14 / $88.50	Professional	26	$25.92	$46.14	$88.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $111.58 / $191.89 / $357.90	Professional	TC	$111.58	$191.89	$357.90