Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $177.83 / $177.83 / $194.98	Facility	26	$177.83	$177.83	$194.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $446.68 / $691.83	Professional		$281.84	$446.68	$691.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $141.25 / $288.40	Professional	26	$85.11	$141.25	$288.40
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $125.89 / $125.89 / $125.89	Professional	52	$125.89	$125.89	$125.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $316.23 / $501.19	Professional	TC	$194.98	$316.23	$501.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $467.74 / $1,584.89	Professional		$275.42	$467.74	$1,584.89
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $128.82 / $478.63	Professional	26	$83.18	$128.82	$478.63
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $338.84 / $1,122.02	Professional	TC	$190.55	$338.84	$1,122.02
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $223.87 / $257.04 / $416.87	Facility	26	$223.87	$257.04	$416.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $741.31 / $1,122.02	Professional		$309.03	$741.31	$1,122.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $186.21 / $338.84	Professional	26	$77.62	$186.21	$338.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $562.34 / $794.33	Professional	TC	$218.78	$562.34	$794.33
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $602.56 / $831.76	Professional		$512.86	$602.56	$831.76
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $154.88 / $186.21 / $251.19	Professional	26	$154.88	$186.21	$251.19
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $354.81 / $416.87 / $588.84	Professional	TC	$354.81	$416.87	$588.84
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $794.33 / $794.33 / $794.33	Facility	26	$794.33	$794.33	$794.33
Medica Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $794.33 / $3,467.37	Professional		$354.81	$794.33	$3,467.37
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $194.98 / $676.08	Professional	26	$91.20	$194.98	$676.08
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $575.44 / $3,019.95	Professional	TC	$251.19	$575.44	$3,019.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $602.56	Professional		$32.36	$33.11	$602.56
Quartz Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $691.83 / $2,454.71	Professional		$354.81	$691.83	$2,454.71
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $194.98 / $776.25 / $776.25	Facility	26	$194.98	$776.25	$776.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $1,995.26 / $3,548.13	Professional		$416.87	$1,995.26	$3,548.13
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $436.52 / $676.08	Professional	26	$104.71	$436.52	$676.08
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $1,698.24 / $3,090.30	Professional	TC	$288.40	$1,698.24	$3,090.30
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $1,862.09 / $2,454.71	Professional		$1,659.59	$1,862.09	$2,454.71
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $363.08 / $512.86 / $660.69	Professional	26	$363.08	$512.86	$660.69
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $977.24 / $1,412.54 / $1,698.24	Professional	TC	$977.24	$1,412.54	$1,698.24
United Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $588.84 / $1,288.25	Professional		$316.23	$588.84	$1,288.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $147.91 / $323.59	Professional	26	$91.20	$147.91	$323.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $457.09 / $1,023.29	Professional	TC	$223.87	$457.09	$1,023.29