Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $112.56 / $112.56 / $389.05	Facility	26	$112.56	$112.56	$389.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $161.82 / $245.59 / $1,159.38	Professional		$161.82	$245.59	$1,159.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $96.29 / $135.86 / $680.00	Professional	26	$96.29	$135.86	$680.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $65.54 / $81.41 / $131.94	Professional	TC	$65.54	$81.41	$131.94
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $171.64 / $250.85 / $699.26	Professional		$171.64	$250.85	$699.26
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $100.50 / $148.72 / $401.78	Professional	26	$100.50	$148.72	$401.78
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $72.30 / $103.03 / $307.74	Professional	TC	$72.30	$103.03	$307.74
CareSource Facility/Professional Professional Modifier Low / Median / High Price $74.48 / $119.63 / $215.33	Professional		$74.48	$119.63	$215.33
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $275.74 / $322.23 / $494.30	Facility	26	$275.74	$322.23	$494.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $177.61 / $429.83 / $569.69	Professional		$177.61	$429.83	$569.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $123.79 / $264.94 / $339.17	Professional	26	$123.79	$264.94	$339.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $91.51 / $182.41 / $252.96	Professional	TC	$91.51	$182.41	$252.96
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $513.00 / $513.00 / $513.00	Facility	26	$513.00	$513.00	$513.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $224.46 / $448.92 / $1,142.65	Professional		$224.46	$448.92	$1,142.65
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $130.22 / $262.16 / $663.65	Professional	26	$130.22	$262.16	$663.65
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $101.03 / $192.29 / $479.00	Professional	TC	$101.03	$192.29	$479.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.72 / $123.82 / $312.79	Professional		$55.72	$123.82	$312.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $280.26 / $400.30 / $570.90	Professional		$280.26	$400.30	$570.90
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $467.77 / $467.77 / $467.77	Facility	26	$467.77	$467.77	$467.77
Quartz Facility/Professional Professional Modifier Low / Median / High Price $253.69 / $935.25 / $1,142.65	Professional		$253.69	$935.25	$1,142.65
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $150.24 / $535.65 / $663.65	Professional	26	$150.24	$535.65	$663.65
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $103.45 / $399.60 / $479.00	Professional	TC	$103.45	$399.60	$479.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $265.76 / $731.60 / $903.58	Professional		$265.76	$731.60	$903.58
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $131.82 / $269.99 / $341.62	Professional	26	$131.82	$269.99	$341.62
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $91.57 / $218.33 / $276.25	Professional	TC	$91.57	$218.33	$276.25
United Facility/Professional Professional Modifier Low / Median / High Price $219.12 / $401.18 / $722.18	Professional		$219.12	$401.18	$722.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $120.35 / $221.76 / $401.74	Professional	26	$120.35	$221.76	$401.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $91.31 / $163.92 / $308.56	Professional	TC	$91.31	$163.92	$308.56