Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.26 / $112.01 / $112.01	Facility	26	$104.26	$112.01	$112.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $160.81 / $280.01 / $429.12	Professional		$160.81	$280.01	$429.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.27 / $70.44 / $264.00	Professional	26	$51.27	$70.44	$264.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $104.98 / $192.08 / $354.57	Professional	TC	$104.98	$192.08	$354.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $148.16 / $350.70 / $1,164.44	Professional		$148.16	$350.70	$1,164.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.13 / $123.95 / $408.89	Professional	26	$52.13	$123.95	$408.89
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $96.04 / $228.02 / $755.55	Professional	TC	$96.04	$228.02	$755.55
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $140.57 / $164.27 / $218.33	Facility	26	$140.57	$164.27	$218.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $210.38 / $535.16 / $608.15	Professional		$210.38	$535.16	$608.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.70 / $187.76 / $213.36	Professional	26	$61.70	$187.76	$213.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $139.96 / $347.40 / $394.78	Professional	TC	$139.96	$347.40	$394.78
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $502.08 / $502.08 / $502.08	Facility	26	$502.08	$502.08	$502.08
Medica Facility/Professional Professional Modifier Low / Median / High Price $189.52 / $469.95 / $1,547.04	Professional		$189.52	$469.95	$1,547.04
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $63.58 / $147.27 / $363.24	Professional	26	$63.58	$147.27	$363.24
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $122.62 / $319.79 / $1,263.33	Professional	TC	$122.62	$319.79	$1,263.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $56.22 / $105.44 / $253.57	Professional		$56.22	$105.44	$253.57
Quartz Facility/Professional Professional Modifier Low / Median / High Price $293.80 / $440.16 / $1,045.74	Professional		$293.80	$440.16	$1,045.74
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $127.55 / $502.08 / $502.08	Facility	26	$127.55	$502.08	$502.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $225.41 / $854.40 / $1,547.04	Professional		$225.41	$854.40	$1,547.04
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $79.08 / $278.75 / $363.24	Professional	26	$79.08	$278.75	$363.24
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $146.33 / $678.53 / $1,263.33	Professional	TC	$146.33	$678.53	$1,263.33
Security Health Facility/Professional Professional Modifier Low / Median / High Price $466.99 / $953.63 / $953.63	Professional		$466.99	$953.63	$953.63
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $186.54 / $197.24 / $303.49	Professional	26	$186.54	$197.24	$303.49
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $288.27 / $339.15 / $912.19	Professional	TC	$288.27	$339.15	$912.19
United Facility/Professional Professional Modifier Low / Median / High Price $182.15 / $417.19 / $1,111.61	Professional		$182.15	$417.19	$1,111.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.82 / $128.09 / $244.33	Professional	26	$60.82	$128.09	$244.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $117.24 / $269.92 / $573.54	Professional	TC	$117.24	$269.92	$573.54