Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.50 / $127.35 / $136.27	Facility	26	$118.50	$127.35	$136.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $172.21 / $317.67 / $1,240.00	Professional		$172.21	$317.67	$1,240.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.68 / $118.50 / $596.60	Professional	26	$60.68	$118.50	$596.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $108.83 / $199.16 / $310.11	Professional	TC	$108.83	$199.16	$310.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $158.83 / $400.41 / $1,243.82	Professional		$158.83	$400.41	$1,243.82
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $59.25 / $140.88 / $463.11	Professional	26	$59.25	$140.88	$463.11
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $99.58 / $253.93 / $780.71	Professional	TC	$99.58	$253.93	$780.71
CareSource Facility/Professional Professional Modifier Low / Median / High Price $67.63 / $120.65 / $219.66	Professional		$67.63	$120.65	$219.66
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $159.50 / $186.39 / $247.72	Facility	26	$159.50	$186.39	$247.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $232.48 / $573.11 / $651.26	Professional		$232.48	$573.11	$651.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.04 / $213.57 / $242.69	Professional	26	$70.04	$213.57	$242.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $144.76 / $359.56 / $408.59	Professional	TC	$144.76	$359.56	$408.59
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $571.36 / $571.36 / $571.36	Facility	26	$571.36	$571.36	$571.36
Medica Facility/Professional Professional Modifier Low / Median / High Price $232.73 / $525.57 / $1,670.68	Professional		$232.73	$525.57	$1,670.68
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $72.23 / $170.70 / $520.49	Professional	26	$72.23	$170.70	$520.49
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $157.13 / $361.29 / $1,318.41	Professional	TC	$157.13	$361.29	$1,318.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $56.22 / $105.44 / $253.92	Professional		$56.22	$105.44	$253.92
Quartz Facility/Professional Professional Modifier Low / Median / High Price $314.60 / $471.32 / $759.88	Professional		$314.60	$471.32	$759.88
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $145.08 / $571.36 / $571.36	Facility	26	$145.08	$571.36	$571.36
Quartz Facility/Professional Professional Modifier Low / Median / High Price $247.97 / $846.40 / $1,670.68	Professional		$247.97	$846.40	$1,670.68
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $89.95 / $314.95 / $520.49	Professional	26	$89.95	$314.95	$520.49
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $154.38 / $611.72 / $1,318.41	Professional	TC	$154.38	$611.72	$1,318.41
Security Health Facility/Professional Professional Modifier Low / Median / High Price $722.21 / $1,021.23 / $1,021.23	Professional		$722.21	$1,021.23	$1,021.23
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $211.90 / $227.59 / $346.27	Professional	26	$211.90	$227.59	$346.27
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $361.49 / $542.77 / $1,210.89	Professional	TC	$361.49	$542.77	$1,210.89
United Facility/Professional Professional Modifier Low / Median / High Price $208.92 / $463.56 / $849.94	Professional		$208.92	$463.56	$849.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $68.75 / $144.37 / $276.05	Professional	26	$68.75	$144.37	$276.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $138.22 / $318.39 / $584.16	Professional	TC	$138.22	$318.39	$584.16