Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.44 / $25.80 / $31.16	Facility	26	$22.44	$25.80	$31.16
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $47.07 / $54.13 / $64.33	Facility	TC	$47.07	$54.13	$64.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.95 / $48.75 / $113.86	Professional		$37.95	$48.75	$113.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.35 / $19.92 / $66.50	Professional	26	$13.35	$19.92	$66.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.51 / $33.54 / $58.20	Professional	TC	$23.51	$33.54	$58.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.60 / $91.67 / $262.23	Professional		$42.60	$91.67	$262.23
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.47 / $34.18 / $93.17	Professional	26	$14.47	$34.18	$93.17
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.56 / $58.91 / $169.66	Professional	TC	$26.56	$58.91	$169.66
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.85 / $44.23 / $58.78	Facility	26	$37.85	$44.23	$58.78
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $85.61 / $100.04 / $132.96	Facility	TC	$85.61	$100.04	$132.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.69 / $160.71 / $182.63	Professional		$48.69	$160.71	$182.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.48 / $51.26 / $58.25	Professional	26	$18.48	$51.26	$58.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.33 / $109.45 / $124.38	Professional	TC	$30.33	$109.45	$124.38
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 $140.77 / $140.77 / $140.77	Facility	TC	$140.77	$140.77	$140.77
Medica Facility/Professional Professional Modifier Low / Median / High Price $46.42 / $108.18 / $297.38	Professional		$46.42	$108.18	$297.38
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $17.60 / $40.44 / $93.99	Professional	26	$17.60	$40.44	$93.99
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $28.99 / $67.38 / $203.39	Professional	TC	$28.99	$67.38	$203.39
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.34 / $43.33 / $74.33	Professional		$19.34	$43.33	$74.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $80.77 / $108.07 / $179.77	Professional		$80.77	$108.07	$179.77
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $34.83 / $70.00 / $70.00	Facility	26	$34.83	$70.00	$70.00
Quartz Facility/Professional Facility Modifier TC Low / Median / High Price $74.34 / $140.77 / $140.77	Facility	TC	$74.34	$140.77	$140.77
Quartz Facility/Professional Professional Modifier Low / Median / High Price $67.69 / $216.35 / $297.38	Professional		$67.69	$216.35	$297.38
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $22.52 / $80.50 / $93.99	Professional	26	$22.52	$80.50	$93.99
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $46.09 / $135.85 / $203.39	Professional	TC	$46.09	$135.85	$203.39
Security Health Facility/Professional Professional Modifier Low / Median / High Price $81.25 / $286.39 / $286.39	Professional		$81.25	$286.39	$286.39
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.40 / $35.77 / $72.15	Professional	26	$30.40	$35.77	$72.15
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $46.33 / $54.51 / $136.33	Professional	TC	$46.33	$54.51	$136.33
United Facility/Professional Professional Modifier Low / Median / High Price $46.13 / $101.61 / $189.63	Professional		$46.13	$101.61	$189.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.17 / $37.81 / $70.65	Professional	26	$17.17	$37.81	$70.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.87 / $63.80 / $119.07	Professional	TC	$28.87	$63.80	$119.07