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 $338.67 / $496.04 / $1,740.70	Professional		$338.67	$496.04	$1,740.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.33 / $73.16 / $331.50	Professional	26	$51.33	$73.16	$331.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $287.33 / $418.00 / $746.10	Professional	TC	$287.33	$418.00	$746.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $291.27 / $632.41 / $1,908.39	Professional		$291.27	$632.41	$1,908.39
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.53 / $80.05 / $244.09	Professional	26	$51.53	$80.05	$244.09
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $208.12 / $552.36 / $1,664.28	Professional	TC	$208.12	$552.36	$1,664.28
CareSource Facility/Professional Professional Modifier Low / Median / High Price $62.00 / $423.96 / $543.51	Professional		$62.00	$423.96	$543.51
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 $485.47 / $1,154.31 / $1,523.17	Professional		$485.47	$1,154.31	$1,523.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.40 / $142.79 / $203.16	Professional	26	$67.40	$142.79	$203.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $425.06 / $1,011.51 / $1,341.34	Professional	TC	$425.06	$1,011.51	$1,341.34
Medica Facility/Professional Professional Modifier Low / Median / High Price $288.06 / $1,007.17 / $2,879.21	Professional		$288.06	$1,007.17	$2,879.21
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $67.54 / $146.44 / $356.25	Professional	26	$67.54	$146.44	$356.25
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $218.58 / $881.01 / $2,522.94	Professional	TC	$218.58	$881.01	$2,522.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.30 / $315.74 / $841.34	Professional		$54.30	$315.74	$841.34
Quartz Facility/Professional Professional Modifier Low / Median / High Price $268.83 / $1,032.74 / $1,463.68	Professional		$268.83	$1,032.74	$1,463.68
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 $654.61 / $2,092.94 / $2,879.21	Professional		$654.61	$2,092.94	$2,879.21
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $93.98 / $286.85 / $356.25	Professional	26	$93.98	$286.85	$356.25
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $591.59 / $1,806.10 / $2,522.94	Professional	TC	$591.59	$1,806.10	$2,522.94
Security Health Facility/Professional Professional Modifier Low / Median / High Price $775.63 / $1,747.96 / $2,331.42	Professional		$775.63	$1,747.96	$2,331.42
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $70.75 / $144.85 / $183.28	Professional	26	$70.75	$144.85	$183.28
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $482.38 / $874.19 / $1,254.02	Professional	TC	$482.38	$874.19	$1,254.02
United Facility/Professional Professional Modifier Low / Median / High Price $323.24 / $905.78 / $1,616.13	Professional		$323.24	$905.78	$1,616.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.22 / $117.33 / $215.14	Professional	26	$63.22	$117.33	$215.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $232.97 / $724.50 / $1,354.57	Professional	TC	$232.97	$724.50	$1,354.57