Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.26 / $48.26 / $166.66	Facility	26	$48.26	$48.26	$166.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $292.89 / $391.99 / $688.07	Professional		$292.89	$391.99	$688.07
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $146.44 / $196.00 / $300.83	Professional	52	$146.44	$196.00	$300.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $252.77 / $343.73 / $618.57	Professional	TC	$252.77	$343.73	$618.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $304.64 / $517.99 / $1,545.61	Professional		$304.64	$517.99	$1,545.61
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $260.86 / $454.21 / $1,351.21	Professional	TC	$260.86	$454.21	$1,351.21
CareSource Facility/Professional Professional Modifier Low / Median / High Price $49.52 / $351.48 / $448.53	Professional		$49.52	$351.48	$448.53
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.05 / $137.94 / $211.61	Facility	26	$118.05	$137.94	$211.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $359.33 / $951.28 / $1,243.27	Professional		$359.33	$951.28	$1,243.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $365.54 / $837.55 / $1,111.40	Professional	TC	$365.54	$837.55	$1,111.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $383.15 / $812.54 / $2,332.00	Professional		$383.15	$812.54	$2,332.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $331.55 / $702.68 / $2,048.28	Professional	TC	$331.55	$702.68	$2,048.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.14 / $309.55 / $736.07	Professional		$58.14	$309.55	$736.07
Quartz Facility/Professional Professional Modifier Low / Median / High Price $594.83 / $860.09 / $1,208.36	Professional		$594.83	$860.09	$1,208.36
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $201.33 / $201.33 / $201.33	Facility	26	$201.33	$201.33	$201.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $499.39 / $1,688.50 / $2,332.00	Professional		$499.39	$1,688.50	$2,332.00
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $423.84 / $1,460.20 / $2,048.28	Professional	TC	$423.84	$1,460.20	$2,048.28
Security Health Facility/Professional Professional Modifier Low / Median / High Price $714.93 / $1,390.76 / $1,921.37	Professional		$714.93	$1,390.76	$1,921.37
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $391.64 / $725.32 / $917.75	Professional	TC	$391.64	$725.32	$917.75
United Facility/Professional Professional Modifier Low / Median / High Price $368.69 / $690.66 / $1,269.27	Professional		$368.69	$690.66	$1,269.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $331.55 / $633.16 / $1,095.15	Professional	TC	$331.55	$633.16	$1,095.15