Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $272.47 / $673.28 / $1,541.29	Facility		$272.47	$673.28	$1,541.29
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.89 / $73.89 / $145.04	Facility	26	$73.89	$73.89	$145.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.53 / $225.03 / $558.00	Professional		$125.53	$225.03	$558.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.74 / $81.45 / $254.36	Professional	26	$42.74	$81.45	$254.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $104.58 / $156.36 / $237.40	Professional	TC	$104.58	$156.36	$237.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $541.00 / $960.00 / $1,964.14	Facility		$541.00	$960.00	$1,964.14
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $157.24 / $212.24 / $625.47	Professional		$157.24	$212.24	$625.47
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $41.41 / $59.08 / $171.36	Professional	26	$41.41	$59.08	$171.36
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $114.30 / $154.69 / $467.33	Professional	TC	$114.30	$154.69	$467.33
CareSource Facility/Professional Facility Modifier Low / Median / High Price $36.45 / $99.55 / $157.72	Facility		$36.45	$99.55	$157.72
CareSource Facility/Professional Professional Modifier Low / Median / High Price $43.22 / $96.29 / $157.72	Professional		$43.22	$96.29	$157.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $372.16 / $434.90 / $667.15	Facility		$372.16	$434.90	$667.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $103.63 / $121.10 / $185.77	Facility	26	$103.63	$121.10	$185.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $175.13 / $355.08 / $642.19	Professional		$175.13	$355.08	$642.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.35 / $98.01 / $185.24	Professional	26	$50.35	$98.01	$185.24
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $123.53 / $240.21 / $456.91	Professional	TC	$123.53	$240.21	$456.91
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $131.03 / $183.93 / $318.79	Facility		$131.03	$183.93	$318.79
Medica Facility/Professional Facility Modifier Low / Median / High Price $138.88 / $213.80 / $472.89	Facility		$138.88	$213.80	$472.89
Medica Facility/Professional Professional Modifier Low / Median / High Price $218.85 / $387.24 / $1,023.12	Professional		$218.85	$387.24	$1,023.12
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $61.44 / $109.86 / $261.30	Professional	26	$61.44	$109.86	$261.30
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $158.55 / $299.10 / $767.60	Professional	TC	$158.55	$299.10	$767.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $56.22 / $106.43 / $260.50	Professional		$56.22	$106.43	$260.50
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $131.03 / $184.56 / $318.79	Facility		$131.03	$184.56	$318.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $207.90 / $308.08 / $437.21	Professional		$207.90	$308.08	$437.21
Quartz Facility/Professional Facility Modifier Low / Median / High Price $588.83 / $588.83 / $588.83	Facility		$588.83	$588.83	$588.83
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $174.10 / $174.10 / $174.10	Facility	26	$174.10	$174.10	$174.10
Quartz Facility/Professional Professional Modifier Low / Median / High Price $197.99 / $1,023.12 / $2,370.90	Professional		$197.99	$1,023.12	$2,370.90
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $57.87 / $206.50 / $261.30	Professional	26	$57.87	$206.50	$261.30
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $137.69 / $767.60 / $2,265.69	Professional	TC	$137.69	$767.60	$2,265.69
Security Health Facility/Professional Facility Modifier Low / Median / High Price $327.88 / $416.68 / $462.41	Facility		$327.88	$416.68	$462.41
Security Health Facility/Professional Professional Modifier Low / Median / High Price $301.95 / $698.99 / $2,064.02	Professional		$301.95	$698.99	$2,064.02
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $50.91 / $130.41 / $296.44	Professional	26	$50.91	$130.41	$296.44
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $146.85 / $308.83 / $2,095.69	Professional	TC	$146.85	$308.83	$2,095.69
United Facility/Professional Professional Modifier Low / Median / High Price $201.53 / $365.71 / $621.37	Professional		$201.53	$365.71	$621.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $62.34 / $104.57 / $188.94	Professional	26	$62.34	$104.57	$188.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $144.57 / $257.91 / $456.81	Professional	TC	$144.57	$257.91	$456.81