Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $107.15 / $213.80 / $213.80	Facility	26	$107.15	$213.80	$213.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $380.19 / $851.14	Professional		$338.84	$380.19	$851.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $109.65 / $229.09	Professional	26	$97.72	$109.65	$229.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $269.15 / $489.78	Professional	TC	$229.09	$269.15	$489.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $707.95 / $1,737.80	Professional		$323.59	$707.95	$1,737.80
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $204.17 / $512.86	Professional	26	$104.71	$204.17	$512.86
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $501.19 / $1,230.27	Professional	TC	$218.78	$501.19	$1,230.27
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $269.15 / $316.23 / $501.19	Facility	26	$269.15	$316.23	$501.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $1,174.90 / $1,348.96	Professional		$467.74	$1,174.90	$1,348.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $154.88 / $331.13 / $380.19	Professional	26	$154.88	$331.13	$380.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $851.14 / $977.24	Professional	TC	$323.59	$851.14	$977.24
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $851.14 / $1,023.29	Professional		$616.60	$851.14	$1,023.29
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $186.21 / $257.04 / $323.59	Professional	26	$186.21	$257.04	$323.59
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $426.58 / $588.84 / $707.95	Professional	TC	$426.58	$588.84	$707.95
Medica Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $549.54 / $1,819.70	Professional		$323.59	$549.54	$1,819.70
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $199.53 / $575.44	Professional	26	$112.20	$199.53	$575.44
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $363.08 / $1,288.25	Professional	TC	$218.78	$363.08	$1,288.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $416.87	Professional		$32.36	$33.11	$416.87
Quartz Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $831.76 / $1,258.93	Professional		$426.58	$831.76	$1,258.93
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $269.15 / $269.15 / $645.65	Facility	26	$269.15	$269.15	$645.65
Quartz Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $1,698.24 / $2,454.71	Professional		$467.74	$1,698.24	$2,454.71
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $141.25 / $524.81 / $758.58	Professional	26	$141.25	$524.81	$758.58
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $1,174.90 / $1,698.24	Professional	TC	$323.59	$1,174.90	$1,698.24
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $2,187.76 / $2,754.23	Professional		$1,288.25	$2,187.76	$2,754.23
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $489.78 / $537.03 / $616.60	Professional	26	$489.78	$537.03	$616.60
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $912.01 / $1,071.52 / $1,258.93	Professional	TC	$912.01	$1,071.52	$1,258.93
United Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $524.81 / $1,479.11	Professional		$316.23	$524.81	$1,479.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $173.78 / $467.74	Professional	26	$104.71	$173.78	$467.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $363.08 / $1,023.29	Professional	TC	$213.80	$363.08	$1,023.29