Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.13 / $26.59 / $32.13	Facility	26	$23.13	$26.59	$32.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.68 / $76.34 / $288.38	Professional		$47.68	$76.34	$288.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.60 / $20.51 / $92.36	Professional	26	$13.60	$20.51	$92.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $32.38 / $41.79 / $74.26	Professional	TC	$32.38	$41.79	$74.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.37 / $103.77 / $295.31	Professional		$48.37	$103.77	$295.31
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.92 / $34.22 / $95.36	Professional	26	$14.92	$34.22	$95.36
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $32.29 / $72.75 / $202.37	Professional	TC	$32.29	$72.75	$202.37
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.54 / $47.39 / $62.98	Facility	26	$40.54	$47.39	$62.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.24 / $184.64 / $209.81	Professional		$56.24	$184.64	$209.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.62 / $54.10 / $61.48	Professional	26	$17.62	$54.10	$61.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.06 / $130.54 / $148.34	Professional	TC	$39.06	$130.54	$148.34
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $55.04 / $128.66 / $338.57	Professional		$55.04	$128.66	$338.57
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $17.62 / $41.92 / $117.24	Professional	26	$17.62	$41.92	$117.24
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $36.69 / $88.07 / $291.00	Professional	TC	$36.69	$88.07	$291.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.71 / $46.68 / $77.04	Professional		$19.71	$46.68	$77.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $102.05 / $152.88 / $201.73	Professional		$102.05	$152.88	$201.73
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $85.53 / $247.30 / $338.57	Professional		$85.53	$247.30	$338.57
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $25.06 / $80.59 / $117.24	Professional	26	$25.06	$80.59	$117.24
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $56.69 / $166.70 / $291.00	Professional	TC	$56.69	$166.70	$291.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $103.65 / $303.33 / $328.99	Professional		$103.65	$303.33	$328.99
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $36.17 / $45.77 / $88.11	Professional	26	$36.17	$45.77	$88.11
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $67.48 / $85.38 / $215.24	Professional	TC	$67.48	$85.38	$215.24
United Facility/Professional Professional Modifier Low / Median / High Price $52.30 / $108.31 / $208.01	Professional		$52.30	$108.31	$208.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.53 / $34.65 / $70.65	Professional	26	$17.53	$34.65	$70.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.71 / $76.13 / $138.16	Professional	TC	$35.71	$76.13	$138.16