Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.58 / $60.58 / $208.84	Facility	26	$60.58	$60.58	$208.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $302.81 / $412.60 / $1,143.00	Professional		$302.81	$412.60	$1,143.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.55 / $65.30 / $332.32	Professional	26	$51.55	$65.30	$332.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $251.27 / $352.02 / $576.02	Professional	TC	$251.27	$352.02	$576.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $247.73 / $545.22 / $1,626.87	Professional		$247.73	$545.22	$1,626.87
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.53 / $80.05 / $242.66	Professional	26	$51.53	$80.05	$242.66
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $185.38 / $465.17 / $1,384.21	Professional	TC	$185.38	$465.17	$1,384.21
CareSource Facility/Professional Professional Modifier Low / Median / High Price $62.00 / $355.78 / $467.63	Professional		$62.00	$355.78	$467.63
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $148.68 / $173.75 / $266.54	Facility	26	$148.68	$173.75	$266.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $417.12 / $1,002.39 / $1,325.46	Professional		$417.12	$1,002.39	$1,325.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.64 / $142.79 / $203.16	Professional	26	$67.64	$142.79	$203.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $356.71 / $859.56 / $1,143.02	Professional	TC	$356.71	$859.56	$1,143.02
Medica Facility/Professional Professional Modifier Low / Median / High Price $280.22 / $849.21 / $2,452.27	Professional		$280.22	$849.21	$2,452.27
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $65.98 / $145.56 / $354.09	Professional	26	$65.98	$145.56	$354.09
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $198.86 / $728.28 / $2,098.17	Professional	TC	$198.86	$728.28	$2,098.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.30 / $263.12 / $709.84	Professional		$54.30	$263.12	$709.84
Quartz Facility/Professional Professional Modifier Low / Median / High Price $256.27 / $886.95 / $1,257.05	Professional		$256.27	$886.95	$1,257.05
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $251.32 / $251.32 / $251.32	Facility	26	$251.32	$251.32	$251.32
Quartz Facility/Professional Professional Modifier Low / Median / High Price $568.45 / $1,764.70 / $2,452.27	Professional		$568.45	$1,764.70	$2,452.27
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $85.66 / $285.10 / $354.09	Professional	26	$85.66	$285.10	$354.09
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $496.30 / $1,479.60 / $2,098.17	Professional	TC	$496.30	$1,479.60	$2,098.17
Security Health Facility/Professional Professional Modifier Low / Median / High Price $678.18 / $1,457.40 / $2,024.57	Professional		$678.18	$1,457.40	$2,024.57
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $70.33 / $143.97 / $182.18	Professional	26	$70.33	$143.97	$182.18
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $401.19 / $742.68 / $1,068.59	Professional	TC	$401.19	$742.68	$1,068.59
United Facility/Professional Professional Modifier Low / Median / High Price $295.68 / $707.90 / $1,323.53	Professional		$295.68	$707.90	$1,323.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.75 / $111.18 / $213.83	Professional	26	$61.75	$111.18	$213.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $217.32 / $593.53 / $1,109.70	Professional	TC	$217.32	$593.53	$1,109.70