Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.50 / $99.58 / $106.97	Facility	26	$48.50	$99.58	$106.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.38 / $275.57 / $1,266.50	Professional		$138.38	$275.57	$1,266.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.79 / $99.58 / $450.50	Professional	26	$49.79	$99.58	$450.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $88.29 / $128.03 / $341.60	Professional	TC	$88.29	$128.03	$341.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $137.78 / $327.62 / $1,075.60	Professional		$137.78	$327.62	$1,075.60
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $49.79 / $114.79 / $390.51	Professional	26	$49.79	$114.79	$390.51
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $87.99 / $209.22 / $685.09	Professional	TC	$87.99	$209.22	$685.09
CareSource Facility/Professional Professional Modifier Low / Median / High Price $56.82 / $106.33 / $190.05	Professional		$56.82	$106.33	$190.05
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $134.27 / $156.90 / $208.54	Facility	26	$134.27	$156.90	$208.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $178.87 / $495.46 / $563.03	Professional		$178.87	$495.46	$563.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.81 / $179.30 / $203.75	Professional	26	$59.81	$179.30	$203.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $112.73 / $316.16 / $359.28	Professional	TC	$112.73	$316.16	$359.28
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $55.50 / $479.84 / $479.84	Facility	26	$55.50	$479.84	$479.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $167.84 / $376.60 / $915.52	Professional		$167.84	$376.60	$915.52
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $60.11 / $129.69 / $323.73	Professional	26	$60.11	$129.69	$323.73
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $107.83 / $245.17 / $591.79	Professional	TC	$107.83	$245.17	$591.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.25 / $101.89 / $250.42	Professional		$55.25	$101.89	$250.42
Quartz Facility/Professional Professional Modifier Low / Median / High Price $251.40 / $330.51 / $475.82	Professional		$251.40	$330.51	$475.82
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $121.80 / $479.84 / $479.84	Facility	26	$121.80	$479.84	$479.84
Quartz Facility/Professional Professional Modifier Low / Median / High Price $208.68 / $605.84 / $915.52	Professional		$208.68	$605.84	$915.52
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $75.51 / $219.24 / $323.73	Professional	26	$75.51	$219.24	$323.73
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $133.16 / $386.60 / $591.79	Professional	TC	$133.16	$386.60	$591.79
Security Health Facility/Professional Professional Modifier Low / Median / High Price $288.52 / $882.83 / $882.83	Professional		$288.52	$882.83	$882.83
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $96.40 / $113.41 / $180.26	Professional	26	$96.40	$113.41	$180.26
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $173.47 / $204.08 / $317.87	Professional	TC	$173.47	$204.08	$317.87
United Facility/Professional Professional Modifier Low / Median / High Price $160.55 / $355.66 / $660.18	Professional		$160.55	$355.66	$660.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.40 / $127.82 / $230.39	Professional	26	$57.40	$127.82	$230.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $104.67 / $236.35 / $488.13	Professional	TC	$104.67	$236.35	$488.13