Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $199.53 / $199.53 / $691.83	Facility	26	$199.53	$199.53	$691.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $371.54 / $1,258.93	Professional		$257.04	$371.54	$1,258.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $169.82 / $239.88 / $870.96	Professional	26	$169.82	$239.88	$870.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $112.20 / $181.97	Professional	TC	$93.33	$112.20	$181.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $407.38 / $933.25	Professional		$288.40	$407.38	$933.25
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $186.21 / $263.03 / $588.84	Professional	26	$186.21	$263.03	$588.84
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $144.54 / $338.84	Professional	TC	$104.71	$144.54	$338.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $239.88 / $363.08	Professional		$112.20	$239.88	$363.08
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $489.78 / $562.34 / $912.01	Facility	26	$489.78	$562.34	$912.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $741.31 / $1,047.13	Professional		$316.23	$741.31	$1,047.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $199.53 / $478.63 / $630.96	Professional	26	$199.53	$478.63	$630.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $263.03 / $380.19	Professional	TC	$117.49	$263.03	$380.19
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $588.84 / $794.33	Professional		$501.19	$588.84	$794.33
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $323.59 / $398.11 / $512.86	Professional	26	$323.59	$398.11	$512.86
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $208.93 / $281.84	Professional	TC	$177.83	$208.93	$281.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $575.44 / $1,862.09	Professional		$338.84	$575.44	$1,862.09
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $208.93 / $363.08 / $1,174.90	Professional	26	$208.93	$363.08	$1,174.90
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $208.93 / $691.83	Professional	TC	$131.83	$208.93	$691.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $338.84	Professional		$32.36	$33.11	$338.84
Quartz Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $660.69 / $977.24	Professional		$389.05	$660.69	$977.24
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $426.58 / $426.58 / $1,174.90	Facility	26	$426.58	$426.58	$1,174.90
Quartz Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $1,479.11 / $1,862.09	Professional		$338.84	$1,479.11	$1,862.09
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $218.78 / $933.25 / $1,174.90	Professional	26	$218.78	$933.25	$1,174.90
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $549.54 / $691.83	Professional	TC	$120.23	$549.54	$691.83
Security Health Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $933.25 / $1,513.56	Professional		$436.52	$933.25	$1,513.56
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $234.42 / $467.74 / $602.56	Professional	26	$234.42	$467.74	$602.56
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $269.15 / $354.81	Professional	TC	$131.83	$269.15	$354.81
United Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $512.86 / $1,047.13	Professional		$323.59	$512.86	$1,047.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $199.53 / $316.23 / $660.69	Professional	26	$199.53	$316.23	$660.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $190.55 / $380.19	Professional	TC	$120.23	$190.55	$380.19