Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $224.47 / $258.14 / $455.74	Facility	26	$224.47	$258.14	$455.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $670.98 / $869.29 / $2,010.38	Professional		$670.98	$869.29	$2,010.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $122.69 / $224.47 / $1,176.14	Professional	26	$122.69	$224.47	$1,176.14
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $248.38 / $359.49 / $579.42	Professional	52	$248.38	$359.49	$579.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $516.91 / $683.99 / $1,186.08	Professional	TC	$516.91	$683.99	$1,186.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $616.00 / $902.69 / $2,564.32	Professional		$616.00	$902.69	$2,564.32
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $124.76 / $174.85 / $506.47	Professional	26	$124.76	$174.85	$506.47
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $491.78 / $727.84 / $2,071.85	Professional	TC	$491.78	$727.84	$2,071.85
CareSource Facility/Professional Professional Modifier Low / Median / High Price $135.72 / $572.76 / $797.29	Professional		$135.72	$572.76	$797.29
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $320.80 / $374.88 / $575.07	Facility	26	$320.80	$374.88	$575.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $814.34 / $1,714.34 / $3,067.78	Professional		$814.34	$1,714.34	$3,067.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $155.72 / $306.93 / $575.53	Professional	26	$155.72	$306.93	$575.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $659.70 / $1,407.41 / $2,492.23	Professional	TC	$659.70	$1,407.41	$2,492.23
Medica Facility/Professional Professional Modifier Low / Median / High Price $840.10 / $1,572.68 / $6,200.00	Professional		$840.10	$1,572.68	$6,200.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $175.50 / $347.76 / $1,081.48	Professional	26	$175.50	$347.76	$1,081.48
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $661.36 / $1,288.85 / $3,875.48	Professional	TC	$661.36	$1,288.85	$3,875.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $107.97 / $450.03 / $1,245.91	Professional		$107.97	$450.03	$1,245.91
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,063.80 / $1,519.46 / $2,237.13	Professional		$1,063.80	$1,519.46	$2,237.13
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $753.90 / $753.90 / $753.90	Facility	26	$753.90	$753.90	$753.90
Quartz Facility/Professional Professional Modifier Low / Median / High Price $988.36 / $3,223.53 / $6,200.00	Professional		$988.36	$3,223.53	$6,200.00
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $204.12 / $717.72 / $1,081.48	Professional	26	$204.12	$717.72	$1,081.48
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $805.87 / $2,505.84 / $3,875.48	Professional	TC	$805.87	$2,505.84	$3,875.48
Security Health Facility/Professional Professional Modifier Low / Median / High Price $984.30 / $3,339.23 / $3,339.23	Professional		$984.30	$3,339.23	$3,339.23
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $154.13 / $317.72 / $722.59	Professional	26	$154.13	$317.72	$722.59
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $492.15 / $1,287.33 / $3,145.58	Professional	TC	$492.15	$1,287.33	$3,145.58
United Facility/Professional Professional Modifier Low / Median / High Price $792.99 / $1,321.49 / $2,378.55	Professional		$792.99	$1,321.49	$2,378.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $150.43 / $284.57 / $484.01	Professional	26	$150.43	$284.57	$484.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $623.19 / $1,113.86 / $1,909.02	Professional	TC	$623.19	$1,113.86	$1,909.02