Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $116.54 / $125.21 / $125.21	Facility	26	$116.54	$125.21	$125.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $210.88 / $380.74 / $593.85	Professional		$210.88	$380.74	$593.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.70 / $77.33 / $203.57	Professional	26	$59.70	$77.33	$203.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $151.18 / $306.18 / $375.83	Professional	TC	$151.18	$306.18	$375.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $211.40 / $531.19 / $1,667.12	Professional		$211.40	$531.19	$1,667.12
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.27 / $143.07 / $457.94	Professional	26	$58.27	$143.07	$457.94
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $153.13 / $390.48 / $1,209.18	Professional	TC	$153.13	$390.48	$1,209.18
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $156.79 / $183.23 / $243.52	Facility	26	$156.79	$183.23	$243.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $306.83 / $760.65 / $864.38	Professional		$306.83	$760.65	$864.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.48 / $209.99 / $238.63	Professional	26	$78.48	$209.99	$238.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $220.57 / $550.66 / $625.75	Professional	TC	$220.57	$550.66	$625.75
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $561.91 / $561.91 / $561.91	Facility	26	$561.91	$561.91	$561.91
Medica Facility/Professional Professional Modifier Low / Median / High Price $287.08 / $648.34 / $2,220.23	Professional		$287.08	$648.34	$2,220.23
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $74.17 / $168.81 / $590.91	Professional	26	$74.17	$168.81	$590.91
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $212.34 / $515.33 / $1,822.59	Professional	TC	$212.34	$515.33	$1,822.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.40 / $165.45 / $385.24	Professional		$58.40	$165.45	$385.24
Quartz Facility/Professional Professional Modifier Low / Median / High Price $415.35 / $622.26 / $1,134.08	Professional		$415.35	$622.26	$1,134.08
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $142.65 / $561.91 / $561.91	Facility	26	$142.65	$561.91	$561.91
Quartz Facility/Professional Professional Modifier Low / Median / High Price $326.45 / $1,276.70 / $2,220.23	Professional		$326.45	$1,276.70	$2,220.23
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $88.45 / $311.45 / $590.91	Professional	26	$88.45	$311.45	$590.91
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $234.38 / $1,038.86 / $1,822.59	Professional	TC	$234.38	$1,038.86	$1,822.59
Security Health Facility/Professional Professional Modifier Low / Median / High Price $972.87 / $1,355.41 / $1,355.41	Professional		$972.87	$1,355.41	$1,355.41
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $211.12 / $257.93 / $389.99	Professional	26	$211.12	$257.93	$389.99
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $553.63 / $734.36 / $1,607.27	Professional	TC	$553.63	$734.36	$1,607.27
United Facility/Professional Professional Modifier Low / Median / High Price $259.25 / $622.33 / $1,048.47	Professional		$259.25	$622.33	$1,048.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $69.33 / $150.12 / $272.99	Professional	26	$69.33	$150.12	$272.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $188.15 / $460.29 / $830.36	Professional	TC	$188.15	$460.29	$830.36