Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $398.11 / $1,148.15	Professional		$331.13	$398.11	$1,148.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $162.18 / $234.42 / $954.99	Professional	26	$162.18	$234.42	$954.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $190.55 / $512.86	Professional	TC	$169.82	$190.55	$512.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $741.31 / $2,238.72	Professional		$173.78	$741.31	$2,238.72
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $269.15 / $1,047.13	Professional	26	$74.13	$269.15	$1,047.13
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $446.68 / $1,348.96	Professional	TC	$100.00	$446.68	$1,348.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,318.26 / $1,949.84	Facility		$1,148.15	$1,318.26	$1,949.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $537.03 / $616.60 / $912.01	Facility	26	$537.03	$616.60	$912.01
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $616.60 / $707.95 / $1,023.29	Facility	TC	$616.60	$707.95	$1,023.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $524.81 / $1,202.26	Professional		$323.59	$524.81	$1,202.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $154.88 / $239.88 / $602.56	Professional	26	$154.88	$239.88	$602.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $275.42 / $707.95	Professional	TC	$173.78	$275.42	$707.95
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $416.87 / $1,445.44	Facility		$331.13	$416.87	$1,445.44
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,000.00 / $1,096.48	Professional		$1,000.00	$1,000.00	$1,096.48
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $478.63 / $478.63 / $524.81	Professional	26	$478.63	$478.63	$524.81
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $524.81 / $524.81 / $575.44	Professional	TC	$524.81	$524.81	$575.44
Medica Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $630.96 / $1,819.70	Facility		$331.13	$630.96	$1,819.70
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $851.14 / $851.14 / $851.14	Facility	26	$851.14	$851.14	$851.14
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $1,445.44 / $1,445.44 / $1,445.44	Facility	TC	$1,445.44	$1,445.44	$1,445.44
Medica Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $588.84 / $5,754.40	Professional		$269.15	$588.84	$5,754.40
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $131.83 / $316.23 / $1,096.48	Professional	26	$131.83	$316.23	$1,096.48
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $446.68 / $2,238.72	Professional	TC	$134.90	$446.68	$2,238.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $50.12 / $70.79	Professional		$32.36	$50.12	$70.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $851.14 / $1,258.93	Professional		$616.60	$851.14	$1,258.93
Quartz Facility/Professional Facility Modifier Low / Median / High Price $851.14 / $851.14 / $2,238.72	Facility		$851.14	$851.14	$2,238.72
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $331.13 / $331.13 / $1,096.48	Facility	26	$331.13	$331.13	$1,096.48
Quartz Facility/Professional Facility Modifier TC Low / Median / High Price $436.52 / $436.52 / $1,445.44	Facility	TC	$436.52	$436.52	$1,445.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $1,659.59 / $5,754.40	Professional		$323.59	$1,659.59	$5,754.40
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $154.88 / $912.01 / $1,096.48	Professional	26	$154.88	$912.01	$1,096.48
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $812.83 / $2,238.72	Professional	TC	$173.78	$812.83	$2,238.72
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,862.09 / $2,570.40	Professional		$1,174.90	$1,862.09	$2,570.40
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $138.04 / $446.68 / $707.95	Professional	26	$138.04	$446.68	$707.95
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $524.81 / $1,047.13	Professional	TC	$218.78	$524.81	$1,047.13
United Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $371.54 / $1,230.27	Professional		$239.88	$371.54	$1,230.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $181.97 / $501.19	Professional	26	$112.20	$181.97	$501.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $208.93 / $831.76	Professional	TC	$120.23	$208.93	$831.76