Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $168.29 / $168.29 / $579.69	Facility	26	$168.29	$168.29	$579.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $233.86 / $339.58 / $1,403.61	Professional		$233.86	$339.58	$1,403.61
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $144.25 / $181.70 / $810.34	Professional	26	$144.25	$181.70	$810.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.35 / $105.08 / $304.98	Professional	TC	$83.35	$105.08	$304.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $239.33 / $354.20 / $957.31	Professional		$239.33	$354.20	$957.31
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $150.26 / $222.39 / $594.52	Professional	26	$150.26	$222.39	$594.52
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $93.20 / $131.82 / $363.38	Professional	TC	$93.20	$131.82	$363.38
CareSource Facility/Professional Professional Modifier Low / Median / High Price $93.64 / $172.22 / $305.27	Professional		$93.64	$172.22	$305.27
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $411.81 / $481.23 / $738.23	Facility	26	$411.81	$481.23	$738.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $243.76 / $598.95 / $793.85	Professional		$243.76	$598.95	$793.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $184.45 / $395.29 / $504.88	Professional	26	$184.45	$395.29	$504.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $117.28 / $235.22 / $331.76	Professional	TC	$117.28	$235.22	$331.76
Medica Facility/Professional Professional Modifier Low / Median / High Price $316.58 / $618.49 / $1,600.14	Professional		$316.58	$618.49	$1,600.14
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $193.06 / $381.42 / $982.86	Professional	26	$193.06	$381.42	$982.86
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $125.55 / $243.32 / $617.27	Professional	TC	$125.55	$243.32	$617.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $77.53 / $183.40 / $441.72	Professional		$77.53	$183.40	$441.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $392.04 / $559.96 / $798.60	Professional		$392.04	$559.96	$798.60
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $699.38 / $699.38 / $699.38	Facility	26	$699.38	$699.38	$699.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $357.57 / $1,285.25 / $1,600.14	Professional		$357.57	$1,285.25	$1,600.14
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $224.16 / $792.60 / $982.86	Professional	26	$224.16	$792.60	$982.86
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $132.00 / $492.65 / $617.27	Professional	TC	$132.00	$492.65	$617.27
Security Health Facility/Professional Professional Modifier Low / Median / High Price $374.03 / $1,016.56 / $1,273.49	Professional		$374.03	$1,016.56	$1,273.49
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $195.74 / $398.48 / $504.20	Professional	26	$195.74	$398.48	$504.20
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $117.89 / $244.38 / $310.16	Professional	TC	$117.89	$244.38	$310.16
United Facility/Professional Professional Modifier Low / Median / High Price $310.52 / $551.08 / $963.94	Professional		$310.52	$551.08	$963.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $190.43 / $328.14 / $594.45	Professional	26	$190.43	$328.14	$594.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $114.99 / $201.51 / $372.70	Professional	TC	$114.99	$201.51	$372.70