Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $137.35 / $487.46 / $487.46	Facility		$137.35	$487.46	$487.46
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.90 / $81.52 / $81.52	Facility	26	$23.90	$81.52	$81.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.81 / $135.81 / $238.67	Professional		$103.81	$135.81	$238.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.05 / $22.93 / $35.65	Professional	26	$13.05	$22.93	$35.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $95.20 / $109.21 / $206.11	Professional	TC	$95.20	$109.21	$206.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $119.01 / $187.62 / $792.52	Professional		$119.01	$187.62	$792.52
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.13 / $28.59 / $119.98	Professional	26	$18.13	$28.59	$119.98
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $100.87 / $159.03 / $672.54	Professional	TC	$100.87	$159.03	$672.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $398.30 / $465.44 / $714.00	Facility		$398.30	$465.44	$714.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.77 / $66.34 / $101.77	Facility	26	$56.77	$66.34	$101.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $158.13 / $339.22 / $497.53	Professional		$158.13	$339.22	$497.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.36 / $51.46 / $71.89	Professional	26	$19.36	$51.46	$71.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $135.22 / $287.92 / $425.64	Professional	TC	$135.22	$287.92	$425.64
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $115.00 / $148.47 / $257.14	Facility		$115.00	$148.47	$257.14
Medica Facility/Professional Facility Modifier Low / Median / High Price $115.00 / $149.30 / $275.85	Facility		$115.00	$149.30	$275.85
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $102.96 / $102.96 / $102.96	Facility	26	$102.96	$102.96	$102.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $158.43 / $298.41 / $1,197.25	Professional		$158.43	$298.41	$1,197.25
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $15.54 / $36.39 / $198.13	Professional	26	$15.54	$36.39	$198.13
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $138.13 / $268.52 / $1,126.14	Professional	TC	$138.13	$268.52	$1,126.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $48.51 / $105.02 / $251.58	Professional		$48.51	$105.02	$251.58
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $113.21 / $148.47 / $254.31	Facility		$113.21	$148.47	$254.31
Quartz Facility/Professional Professional Modifier Low / Median / High Price $252.24 / $343.73 / $477.40	Professional		$252.24	$343.73	$477.40
Quartz Facility/Professional Facility Modifier Low / Median / High Price $147.68 / $305.85 / $601.01	Facility		$147.68	$305.85	$601.01
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $26.75 / $100.00 / $102.96	Facility	26	$26.75	$100.00	$102.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $198.11 / $646.29 / $1,197.25	Professional		$198.11	$646.29	$1,197.25
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $25.24 / $116.00 / $198.13	Professional	26	$25.24	$116.00	$198.13
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $162.66 / $530.29 / $1,126.14	Professional	TC	$162.66	$530.29	$1,126.14
Security Health Facility/Professional Professional Modifier Low / Median / High Price $275.60 / $492.23 / $657.11	Professional		$275.60	$492.23	$657.11
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $35.79 / $59.15 / $74.84	Professional	26	$35.79	$59.15	$74.84
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $256.14 / $329.87 / $499.12	Professional	TC	$256.14	$329.87	$499.12
United Facility/Professional Professional Modifier Low / Median / High Price $158.12 / $264.24 / $498.96	Professional		$158.12	$264.24	$498.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.58 / $34.65 / $76.26	Professional	26	$15.58	$34.65	$76.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $132.54 / $241.17 / $470.93	Professional	TC	$132.54	$241.17	$470.93