Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $199.52 / $199.52 / $687.92	Facility	26	$199.52	$199.52	$687.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $273.81 / $365.63 / $1,860.85	Professional		$273.81	$365.63	$1,860.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $171.18 / $213.92 / $983.80	Professional	26	$171.18	$213.92	$983.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $92.42 / $116.09 / $189.51	Professional	TC	$92.42	$116.09	$189.51
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $276.54 / $409.29 / $1,106.18	Professional		$276.54	$409.29	$1,106.18
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $178.14 / $263.64 / $705.87	Professional	26	$178.14	$263.64	$705.87
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $102.57 / $145.63 / $402.58	Professional	TC	$102.57	$145.63	$402.58
CareSource Facility/Professional Professional Modifier Low / Median / High Price $107.11 / $204.35 / $357.69	Professional		$107.11	$204.35	$357.69
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $485.70 / $567.58 / $870.69	Facility	26	$485.70	$567.58	$870.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $292.44 / $701.25 / $929.44	Professional		$292.44	$701.25	$929.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $218.90 / $467.45 / $598.79	Professional	26	$218.90	$467.45	$598.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $130.76 / $260.64 / $370.93	Professional	TC	$130.76	$260.64	$370.93
Medica Facility/Professional Professional Modifier Low / Median / High Price $367.23 / $714.48 / $1,850.58	Professional		$367.23	$714.48	$1,850.58
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $229.01 / $452.86 / $1,166.03	Professional	26	$229.01	$452.86	$1,166.03
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $139.05 / $263.44 / $684.55	Professional	TC	$139.05	$263.44	$684.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.93 / $207.23 / $562.82	Professional		$78.93	$207.23	$562.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $459.00 / $655.61 / $935.00	Professional		$459.00	$655.61	$935.00
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $829.58 / $829.58 / $829.58	Facility	26	$829.58	$829.58	$829.58
Quartz Facility/Professional Professional Modifier Low / Median / High Price $412.91 / $1,488.50 / $1,850.58	Professional		$412.91	$1,488.50	$1,850.58
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $265.10 / $941.05 / $1,166.03	Professional	26	$265.10	$941.05	$1,166.03
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $147.81 / $547.45 / $684.55	Professional	TC	$147.81	$547.45	$684.55
Security Health Facility/Professional Professional Modifier Low / Median / High Price $433.09 / $1,181.00 / $1,470.60	Professional		$433.09	$1,181.00	$1,470.60
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $232.06 / $471.42 / $596.49	Professional	26	$232.06	$471.42	$596.49
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $130.78 / $266.95 / $346.78	Professional	TC	$130.78	$266.95	$346.78
United Facility/Professional Professional Modifier Low / Median / High Price $357.24 / $608.86 / $1,116.38	Professional		$357.24	$608.86	$1,116.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $225.85 / $388.91 / $705.79	Professional	26	$225.85	$388.91	$705.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $130.63 / $225.82 / $412.22	Professional	TC	$130.63	$225.82	$412.22