Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.71 / $120.23 / $177.83	Facility	26	$104.71	$120.23	$177.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $446.68 / $912.01	Professional		$338.84	$446.68	$912.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $93.33 / $316.23	Professional	26	$53.70	$93.33	$316.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $380.19 / $691.83	Professional	TC	$288.40	$380.19	$691.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $588.84 / $1,445.44	Professional		$407.38	$588.84	$1,445.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $83.18 / $208.93	Professional	26	$57.54	$83.18	$208.93
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $346.74 / $512.86 / $1,288.25	Professional	TC	$346.74	$512.86	$1,288.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $147.91 / $173.78 / $281.84	Facility	26	$147.91	$173.78	$281.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $1,148.15 / $2,089.30	Professional		$512.86	$1,148.15	$2,089.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $141.25 / $275.42	Professional	26	$67.61	$141.25	$275.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $436.52 / $1,000.00 / $1,778.28	Professional	TC	$436.52	$1,000.00	$1,778.28
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $912.01 / $1,230.27	Professional		$776.25	$912.01	$1,230.27
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $117.49 / $158.49	Professional	26	$100.00	$117.49	$158.49
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $676.08 / $794.33 / $1,071.52	Professional	TC	$676.08	$794.33	$1,071.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $954.99 / $3,890.45	Professional		$478.63	$954.99	$3,890.45
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $144.54 / $616.60	Professional	26	$74.13	$144.54	$616.60
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $407.38 / $812.83 / $3,548.13	Professional	TC	$407.38	$812.83	$3,548.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $177.83	Professional		$32.36	$33.11	$177.83
Quartz Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $1,071.52 / $1,584.89	Professional		$512.86	$1,071.52	$1,584.89
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $131.83 / $416.87 / $416.87	Facility	26	$131.83	$416.87	$416.87
Quartz Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $2,344.23 / $3,890.45	Professional		$512.86	$2,344.23	$3,890.45
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $354.81 / $616.60	Professional	26	$70.79	$354.81	$616.60
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $446.68 / $2,041.74 / $3,715.35	Professional	TC	$446.68	$2,041.74	$3,715.35
Security Health Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $1,318.26 / $2,290.87	Professional		$338.84	$1,318.26	$2,290.87
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $147.91 / $229.09	Professional	26	$72.44	$147.91	$229.09
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $436.52 / $891.25 / $1,380.38	Professional	TC	$436.52	$891.25	$1,380.38
United Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $741.31 / $1,513.56	Professional		$467.74	$741.31	$1,513.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $112.20 / $218.78	Professional	26	$64.57	$112.20	$218.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $398.11 / $645.65 / $1,288.25	Professional	TC	$398.11	$645.65	$1,288.25