Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $223.87 / $257.04 / $3,890.45	Facility	26	$223.87	$257.04	$3,890.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $758.58 / $1,548.82	Professional		$575.44	$758.58	$1,548.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $223.87 / $741.31	Professional	26	$117.49	$223.87	$741.31
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $199.53 / $199.53 / $257.04	Professional	52	$199.53	$199.53	$257.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $457.09 / $588.84 / $1,122.02	Professional	TC	$457.09	$588.84	$1,122.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $912.01 / $2,238.72	Professional		$630.96	$912.01	$2,238.72
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $125.89 / $173.78 / $426.58	Professional	26	$125.89	$173.78	$426.58
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $501.19 / $724.44 / $1,778.28	Professional	TC	$501.19	$724.44	$1,778.28
CareSource Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $645.65 / $831.76	Professional		$144.54	$645.65	$831.76
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $323.59 / $371.54 / $602.56	Facility	26	$323.59	$371.54	$602.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,698.24 / $3,162.28	Professional		$776.25	$1,698.24	$3,162.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $144.54 / $309.03 / $588.84	Professional	26	$144.54	$309.03	$588.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $630.96 / $1,412.54 / $2,570.40	Professional	TC	$630.96	$1,412.54	$2,570.40
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,380.38 / $1,819.70	Professional		$1,174.90	$1,380.38	$1,819.70
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $213.80 / $251.19 / $338.84	Professional	26	$213.80	$251.19	$338.84
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $954.99 / $1,122.02 / $1,513.56	Professional	TC	$954.99	$1,122.02	$1,513.56
Medica Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,412.54 / $6,165.95	Professional		$794.33	$1,412.54	$6,165.95
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $154.88 / $309.03 / $1,071.52	Professional	26	$154.88	$309.03	$1,071.52
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $630.96 / $1,122.02 / $3,890.45	Professional	TC	$630.96	$1,122.02	$3,890.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $776.25	Professional		$32.36	$33.11	$776.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,584.89 / $2,344.23	Professional		$912.01	$1,584.89	$2,344.23
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $281.84 / $776.25 / $776.25	Facility	26	$281.84	$776.25	$776.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $3,235.94 / $6,165.95	Professional		$812.83	$3,235.94	$6,165.95
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $151.36 / $724.44 / $1,071.52	Professional	26	$151.36	$724.44	$1,071.52
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $660.69 / $2,511.89 / $3,981.07	Professional	TC	$660.69	$2,511.89	$3,981.07
Security Health Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $2,041.74 / $4,073.80	Professional		$977.24	$2,041.74	$4,073.80
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $190.55 / $380.19 / $954.99	Professional	26	$190.55	$380.19	$954.99
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $489.78 / $1,288.25 / $3,890.45	Professional	TC	$489.78	$1,288.25	$3,890.45
United Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $1,148.15 / $2,290.87	Professional		$741.31	$1,148.15	$2,290.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $141.25 / $239.88 / $467.74	Professional	26	$141.25	$239.88	$467.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $588.84 / $912.01 / $1,819.70	Professional	TC	$588.84	$912.01	$1,819.70