Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $489.78 / $489.78	Facility		$138.04	$489.78	$489.78
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.91 / $81.28 / $81.28	Facility	26	$22.91	$81.28	$81.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $138.04 / $309.03	Professional		$102.33	$138.04	$309.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $23.99 / $51.29	Professional	26	$17.38	$23.99	$51.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $114.82 / $194.98	Professional	TC	$91.20	$114.82	$194.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $208.93 / $691.83	Professional		$141.25	$208.93	$691.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $31.62 / $102.33	Professional	26	$21.88	$31.62	$102.33
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $177.83 / $602.56	Professional	TC	$117.49	$177.83	$602.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $467.74 / $741.31	Facility		$398.11	$467.74	$741.31
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.41 / $64.57 / $91.20	Facility	26	$7.41	$64.57	$91.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $309.03 / $426.58	Professional		$147.91	$309.03	$426.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $45.71 / $66.07	Professional	26	$19.50	$45.71	$66.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $263.03 / $363.08	Professional	TC	$131.83	$263.03	$363.08
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $144.54 / $218.78	Facility		$114.82	$144.54	$218.78
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $302.00 / $426.58	Professional		$257.04	$302.00	$426.58
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $45.71 / $64.57	Professional	26	$38.90	$45.71	$64.57
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $257.04 / $363.08	Professional	TC	$218.78	$257.04	$363.08
Medica Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $147.91 / $275.42	Facility		$114.82	$147.91	$275.42
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $102.33 / $102.33 / $102.33	Facility	26	$102.33	$102.33	$102.33
Medica Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $302.00 / $1,202.26	Professional		$158.49	$302.00	$1,202.26
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $37.15 / $199.53	Professional	26	$15.49	$37.15	$199.53
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $269.15 / $1,122.02	Professional	TC	$138.04	$269.15	$1,122.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $85.11	Professional		$32.36	$33.11	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $338.84 / $478.63	Professional		$223.87	$338.84	$478.63
Quartz Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $302.00 / $851.14	Facility		$302.00	$302.00	$851.14
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $144.54	Facility	26	$100.00	$100.00	$144.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $645.65 / $1,230.27	Professional		$158.49	$645.65	$1,230.27
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $114.82 / $199.53	Professional	26	$19.50	$114.82	$199.53
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $524.81 / $1,148.15	Professional	TC	$134.90	$524.81	$1,148.15
Security Health Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $467.74 / $660.69	Professional		$275.42	$467.74	$660.69
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $58.88 / $72.44	Professional	26	$36.31	$58.88	$72.44
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $331.13 / $501.19	Professional	TC	$257.04	$331.13	$501.19
United Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $229.09 / $467.74	Professional		$151.36	$229.09	$467.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $28.18 / $72.44	Professional	26	$14.79	$28.18	$72.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $204.17 / $398.11	Professional	TC	$128.82	$204.17	$398.11