Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.84 / $22.81 / $27.56	Facility	26	$19.84	$22.81	$27.56
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $43.58 / $50.11 / $60.14	Facility	TC	$43.58	$50.11	$60.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.39 / $44.51 / $106.30	Professional		$35.39	$44.51	$106.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.80 / $15.21 / $46.61	Professional	26	$11.80	$15.21	$46.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.85 / $31.06 / $54.42	Professional	TC	$22.85	$31.06	$54.42
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.38 / $84.27 / $244.11	Professional		$39.38	$84.27	$244.11
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.80 / $29.57 / $80.30	Professional	26	$12.80	$29.57	$80.30
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.50 / $57.01 / $158.75	Professional	TC	$25.50	$57.01	$158.75
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.24 / $40.02 / $53.18	Facility	26	$34.24	$40.02	$53.18
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $80.20 / $93.72 / $124.56	Facility	TC	$80.20	$93.72	$124.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.40 / $148.79 / $169.08	Professional		$45.40	$148.79	$169.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.04 / $46.37 / $52.69	Professional	26	$16.04	$46.37	$52.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.20 / $102.42 / $116.39	Professional	TC	$29.20	$102.42	$116.39
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $70.00 / $70.00 / $70.00	Facility	26	$70.00	$70.00	$70.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $131.69 / $131.69 / $131.69	Facility	TC	$131.69	$131.69	$131.69
Medica Facility/Professional Professional Modifier Low / Median / High Price $43.21 / $99.43 / $271.47	Professional		$43.21	$99.43	$271.47
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $15.53 / $34.46 / $81.06	Professional	26	$15.53	$34.46	$81.06
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $27.99 / $65.34 / $190.40	Professional	TC	$27.99	$65.34	$190.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.34 / $38.97 / $74.33	Professional		$19.34	$38.97	$74.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $75.30 / $99.39 / $167.34	Professional		$75.30	$99.39	$167.34
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $31.50 / $70.00 / $70.00	Facility	26	$31.50	$70.00	$70.00
Quartz Facility/Professional Facility Modifier TC Low / Median / High Price $69.58 / $131.69 / $131.69	Facility	TC	$69.58	$131.69	$131.69
Quartz Facility/Professional Professional Modifier Low / Median / High Price $62.66 / $198.85 / $271.47	Professional		$62.66	$198.85	$271.47
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $20.02 / $68.15 / $81.06	Professional	26	$20.02	$68.15	$81.06
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $43.13 / $130.75 / $190.40	Professional	TC	$43.13	$130.75	$190.40
Security Health Facility/Professional Professional Modifier Low / Median / High Price $75.64 / $265.12 / $265.12	Professional		$75.64	$265.12	$265.12
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.40 / $31.06 / $62.42	Professional	26	$26.40	$31.06	$62.42
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $45.04 / $52.99 / $131.62	Professional	TC	$45.04	$52.99	$131.62
United Facility/Professional Professional Modifier Low / Median / High Price $41.86 / $91.62 / $174.29	Professional		$41.86	$91.62	$174.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.65 / $73.00 / $104.85	Professional	26	$22.65	$73.00	$104.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.79 / $61.38 / $112.22	Professional	TC	$27.79	$61.38	$112.22