Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.18 / $97.72 / $97.72	Facility	26	$83.18	$97.72	$97.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $223.87 / $707.95	Professional		$125.89	$223.87	$707.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $95.50 / $338.84	Professional	26	$72.44	$95.50	$338.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $61.66 / $117.49	Professional	TC	$51.29	$61.66	$117.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $190.55 / $457.09	Professional		$138.04	$190.55	$457.09
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $112.20 / $251.19	Professional	26	$77.62	$112.20	$251.19
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $79.43 / $190.55	Professional	TC	$57.54	$79.43	$190.55
CareSource Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $102.33 / $165.96	Professional		$60.26	$102.33	$165.96
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $208.93 / $239.88 / $389.05	Facility	26	$208.93	$239.88	$389.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $346.74 / $489.78	Professional		$158.49	$346.74	$489.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $204.17 / $269.15	Professional	26	$85.11	$204.17	$269.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $147.91 / $204.17	Professional	TC	$64.57	$147.91	$204.17
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $275.42 / $371.54	Professional		$234.42	$275.42	$371.54
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $138.04 / $162.18 / $218.78	Professional	26	$138.04	$162.18	$218.78
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $120.23 / $162.18	Professional	TC	$97.72	$120.23	$162.18
Medica Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $275.42 / $870.96	Professional		$154.88	$275.42	$870.96
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $158.49 / $501.19	Professional	26	$89.13	$158.49	$501.19
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $123.03 / $380.19	Professional	TC	$70.79	$123.03	$380.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $85.11	Professional		$32.36	$33.11	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $316.23 / $467.74	Professional		$186.21	$316.23	$467.74
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $181.97 / $181.97 / $501.19	Facility	26	$181.97	$181.97	$501.19
Quartz Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $707.95 / $870.96	Professional		$158.49	$707.95	$870.96
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $398.11 / $501.19	Professional	26	$91.20	$398.11	$501.19
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $309.03 / $380.19	Professional	TC	$69.18	$309.03	$380.19
Security Health Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $467.74 / $707.95	Professional		$194.98	$467.74	$707.95
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $204.17 / $257.04	Professional	26	$97.72	$204.17	$257.04
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $165.96 / $213.80	Professional	TC	$72.44	$165.96	$213.80
United Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $239.88 / $501.19	Professional		$147.91	$239.88	$501.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $134.90 / $281.84	Professional	26	$83.18	$134.90	$281.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $104.71 / $218.78	Professional	TC	$66.07	$104.71	$218.78