Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.75 / $172.19 / $306.89	Facility	26	$85.75	$172.19	$306.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $288.00 / $344.71 / $1,027.68	Professional		$288.00	$344.71	$1,027.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $80.08 / $87.73 / $286.07	Professional	26	$80.08	$87.73	$286.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $200.28 / $231.34 / $622.27	Professional	TC	$200.28	$231.34	$622.27
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $272.98 / $793.11 / $2,064.79	Professional		$272.98	$793.11	$2,064.79
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $84.42 / $224.49 / $579.63	Professional	26	$84.42	$224.49	$579.63
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $192.33 / $575.85 / $1,384.65	Professional	TC	$192.33	$575.85	$1,384.65
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $216.27 / $252.73 / $407.64	Facility	26	$216.27	$252.73	$407.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $420.05 / $956.02 / $1,201.34	Professional		$420.05	$956.02	$1,201.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $125.43 / $261.89 / $346.74	Professional	26	$125.43	$261.89	$346.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $294.62 / $694.12 / $854.61	Professional	TC	$294.62	$694.12	$854.61
Medica Facility/Professional Professional Modifier Low / Median / High Price $328.36 / $774.45 / $1,782.64	Professional		$328.36	$774.45	$1,782.64
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $98.81 / $249.94 / $684.00	Professional	26	$98.81	$249.94	$684.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $227.40 / $621.30 / $1,600.96	Professional	TC	$227.40	$621.30	$1,600.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $81.79 / $224.77 / $583.02	Professional		$81.79	$224.77	$583.02
Quartz Facility/Professional Professional Modifier Low / Median / High Price $540.79 / $832.00 / $1,073.61	Professional		$540.79	$832.00	$1,073.61
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $378.47 / $378.47 / $378.47	Facility	26	$378.47	$378.47	$378.47
Quartz Facility/Professional Professional Modifier Low / Median / High Price $426.03 / $1,408.10 / $2,227.92	Professional		$426.03	$1,408.10	$2,227.92
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $116.70 / $417.15 / $684.00	Professional	26	$116.70	$417.15	$684.00
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $309.33 / $990.95 / $1,600.96	Professional	TC	$309.33	$990.95	$1,600.96
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,005.82 / $1,807.71 / $1,807.71	Professional		$1,005.82	$1,807.71	$1,807.71
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $214.74 / $408.48 / $458.17	Professional	26	$214.74	$408.48	$458.17
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $792.84 / $888.58 / $932.75	Professional	TC	$792.84	$888.58	$932.75
United Facility/Professional Professional Modifier Low / Median / High Price $312.72 / $895.46 / $1,405.43	Professional		$312.72	$895.46	$1,405.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $96.59 / $256.38 / $416.36	Professional	26	$96.59	$256.38	$416.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $223.88 / $699.61 / $956.00	Professional	TC	$223.88	$699.61	$956.00