Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $140.41 / $140.41 / $484.97	Facility	26	$140.41	$140.41	$484.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $212.72 / $298.16 / $1,496.00	Professional		$212.72	$298.16	$1,496.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $120.35 / $151.60 / $656.27	Professional	26	$120.35	$151.60	$656.27
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $74.94 / $93.56 / $148.97	Professional	TC	$74.94	$93.56	$148.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $206.40 / $302.93 / $840.86	Professional		$206.40	$302.93	$840.86
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $125.38 / $185.56 / $499.00	Professional	26	$125.38	$185.56	$499.00
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $83.94 / $118.97 / $345.17	Professional	TC	$83.94	$118.97	$345.17
CareSource Facility/Professional Professional Modifier Low / Median / High Price $84.05 / $149.44 / $261.52	Professional		$84.05	$149.44	$261.52
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $344.23 / $402.26 / $617.07	Facility	26	$344.23	$402.26	$617.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $213.75 / $514.79 / $682.32	Professional		$213.75	$514.79	$682.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $154.32 / $330.96 / $422.02	Professional	26	$154.32	$330.96	$422.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $104.69 / $208.69 / $293.20	Professional	TC	$104.69	$208.69	$293.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $270.16 / $539.05 / $1,374.92	Professional		$270.16	$539.05	$1,374.92
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $162.51 / $327.33 / $824.31	Professional	26	$162.51	$327.33	$824.31
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $116.28 / $220.30 / $550.61	Professional	TC	$116.28	$220.30	$550.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $56.25 / $138.03 / $437.32	Professional		$56.25	$138.03	$437.32
Quartz Facility/Professional Professional Modifier Low / Median / High Price $336.42 / $480.52 / $685.30	Professional		$336.42	$480.52	$685.30
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $584.34 / $584.34 / $584.34	Facility	26	$584.34	$584.34	$584.34
Quartz Facility/Professional Professional Modifier Low / Median / High Price $306.02 / $1,123.05 / $1,374.92	Professional		$306.02	$1,123.05	$1,374.92
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $187.68 / $665.25 / $824.31	Professional	26	$187.68	$665.25	$824.31
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $118.12 / $457.80 / $550.61	Professional	TC	$118.12	$457.80	$550.61
Security Health Facility/Professional Professional Modifier Low / Median / High Price $314.98 / $879.40 / $1,089.93	Professional		$314.98	$879.40	$1,089.93
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $118.12 / $337.07 / $426.49	Professional	26	$118.12	$337.07	$426.49
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $105.29 / $245.24 / $310.30	Professional	TC	$105.29	$245.24	$310.30
United Facility/Professional Professional Modifier Low / Median / High Price $266.32 / $477.59 / $862.92	Professional		$266.32	$477.59	$862.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $159.66 / $277.79 / $498.94	Professional	26	$159.66	$277.79	$498.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $107.45 / $208.56 / $353.50	Professional	TC	$107.45	$208.56	$353.50