Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.69 / $86.69 / $297.89	Facility	26	$86.69	$86.69	$297.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $130.08 / $173.70 / $514.00	Professional		$130.08	$173.70	$514.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.04 / $86.69 / $129.43	Professional	26	$75.04	$86.69	$129.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $55.03 / $87.01 / $141.40	Professional	TC	$55.03	$87.01	$141.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $118.43 / $229.53 / $697.46	Professional		$118.43	$229.53	$697.46
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $73.62 / $114.55 / $348.45	Professional	26	$73.62	$114.55	$348.45
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $41.00 / $114.98 / $348.01	Professional	TC	$41.00	$114.98	$348.01
CareSource Facility/Professional Professional Modifier Low / Median / High Price $77.00 / $91.79 / $178.45	Professional		$77.00	$91.79	$178.45
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $211.76 / $247.46 / $379.61	Facility	26	$211.76	$247.46	$379.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $126.37 / $406.24 / $508.46	Professional		$126.37	$406.24	$508.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $98.02 / $203.59 / $291.11	Professional	26	$98.02	$203.59	$291.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $88.45 / $202.76 / $284.91	Professional	TC	$88.45	$202.76	$284.91
Medica Facility/Professional Professional Modifier Low / Median / High Price $155.99 / $403.24 / $1,053.48	Professional		$155.99	$403.24	$1,053.48
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $91.88 / $215.73 / $509.36	Professional	26	$91.88	$215.73	$509.36
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $48.94 / $206.30 / $544.05	Professional	TC	$48.94	$206.30	$544.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $56.25 / $123.76 / $306.58	Professional		$56.25	$123.76	$306.58
Quartz Facility/Professional Professional Modifier Low / Median / High Price $249.48 / $369.61 / $508.20	Professional		$249.48	$369.61	$508.20
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $358.77 / $358.77 / $358.77	Facility	26	$358.77	$358.77	$358.77
Quartz Facility/Professional Professional Modifier Low / Median / High Price $230.44 / $837.95 / $1,053.48	Professional		$230.44	$837.95	$1,053.48
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $133.99 / $409.25 / $509.36	Professional	26	$133.99	$409.25	$509.36
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $114.23 / $428.70 / $544.05	Professional	TC	$114.23	$428.70	$544.05
Security Health Facility/Professional Professional Modifier Low / Median / High Price $244.10 / $668.80 / $820.75	Professional		$244.10	$668.80	$820.75
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $100.99 / $206.97 / $261.88	Professional	26	$100.99	$206.97	$261.88
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $104.04 / $221.80 / $280.64	Professional	TC	$104.04	$221.80	$280.64
United Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $341.00 / $628.46	Professional		$154.88	$341.00	$628.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $91.33 / $164.17 / $313.30	Professional	26	$91.33	$164.17	$313.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $48.94 / $160.57 / $321.52	Professional	TC	$48.94	$160.57	$321.52