Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $148.84 / $160.00 / $160.00	Facility	26	$148.84	$160.00	$160.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $241.92 / $445.44 / $1,378.73	Professional		$241.92	$445.44	$1,378.73
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.00 / $116.31 / $637.50	Professional	26	$69.00	$116.31	$637.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $146.41 / $296.60 / $526.09	Professional	TC	$146.41	$296.60	$526.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $222.72 / $539.33 / $1,747.06	Professional		$222.72	$539.33	$1,747.06
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $74.42 / $172.17 / $583.17	Professional	26	$74.42	$172.17	$583.17
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $148.30 / $361.47 / $1,163.89	Professional	TC	$148.30	$361.47	$1,163.89
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $199.15 / $232.72 / $309.30	Facility	26	$199.15	$232.72	$309.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $323.10 / $798.08 / $906.91	Professional		$323.10	$798.08	$906.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.89 / $267.37 / $303.83	Professional	26	$78.89	$267.37	$303.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $212.89 / $530.72 / $603.09	Professional	TC	$212.89	$530.72	$603.09
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $714.16 / $714.16 / $714.16	Facility	26	$714.16	$714.16	$714.16
Medica Facility/Professional Professional Modifier Low / Median / High Price $284.02 / $646.57 / $2,036.01	Professional		$284.02	$646.57	$2,036.01
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $87.43 / $203.84 / $484.69	Professional	26	$87.43	$203.84	$484.69
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $187.96 / $490.20 / $2,005.00	Professional	TC	$187.96	$490.20	$2,005.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $76.01 / $180.22 / $424.06	Professional		$76.01	$180.22	$424.06
Quartz Facility/Professional Professional Modifier Low / Median / High Price $436.80 / $654.39 / $1,167.24	Professional		$436.80	$654.39	$1,167.24
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $181.63 / $714.16 / $714.16	Facility	26	$181.63	$714.16	$714.16
Quartz Facility/Professional Professional Modifier Low / Median / High Price $336.13 / $1,183.45 / $2,036.01	Professional		$336.13	$1,183.45	$2,036.01
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $112.60 / $400.30 / $484.69	Professional	26	$112.60	$400.30	$484.69
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $226.28 / $925.44 / $2,005.00	Professional	TC	$226.28	$925.44	$2,005.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $899.11 / $1,422.08 / $1,422.08	Professional		$899.11	$1,422.08	$1,422.08
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $239.65 / $257.93 / $389.99	Professional	26	$239.65	$257.93	$389.99
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $533.58 / $734.35 / $1,406.25	Professional	TC	$533.58	$734.35	$1,406.25
United Facility/Professional Professional Modifier Low / Median / High Price $258.70 / $615.69 / $1,037.29	Professional		$258.70	$615.69	$1,037.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $83.37 / $183.34 / $398.49	Professional	26	$83.37	$183.34	$398.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $172.21 / $395.58 / $770.50	Professional	TC	$172.21	$395.58	$770.50