Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $224.03 / $224.03 / $250.22	Facility	26	$224.03	$224.03	$250.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $661.50 / $2,180.25	Professional		$475.00	$661.50	$2,180.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $109.41 / $176.40 / $635.97	Professional	26	$109.41	$176.40	$635.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $436.93 / $838.55	Professional	TC	$335.00	$436.93	$838.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $478.12 / $1,174.65 / $3,797.18	Professional		$478.12	$1,174.65	$3,797.18
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $104.26 / $247.90 / $815.27	Professional	26	$104.26	$247.90	$815.27
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $373.86 / $934.99 / $2,981.91	Professional	TC	$373.86	$934.99	$2,981.91
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $280.25 / $327.49 / $435.26	Facility	26	$280.25	$327.49	$435.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $684.23 / $1,705.42 / $1,937.98	Professional		$684.23	$1,705.42	$1,937.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $121.68 / $374.34 / $425.39	Professional	26	$121.68	$374.34	$425.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $529.90 / $1,331.08 / $1,512.59	Professional	TC	$529.90	$1,331.08	$1,512.59
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $1,000.96 / $1,000.96 / $1,000.96	Facility	26	$1,000.96	$1,000.96	$1,000.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $695.55 / $1,674.51 / $5,967.97	Professional		$695.55	$1,674.51	$5,967.97
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $133.25 / $300.92 / $937.83	Professional	26	$133.25	$300.92	$937.83
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $551.20 / $1,339.56 / $5,400.50	Professional	TC	$551.20	$1,339.56	$5,400.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $80.83 / $309.39 / $859.12	Professional		$80.83	$309.39	$859.12
Quartz Facility/Professional Professional Modifier Low / Median / High Price $927.55 / $1,389.61 / $2,441.92	Professional		$927.55	$1,389.61	$2,441.92
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $254.30 / $1,000.96 / $1,000.96	Facility	26	$254.30	$1,000.96	$1,000.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $718.28 / $3,259.89 / $5,967.97	Professional		$718.28	$3,259.89	$5,967.97
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $157.66 / $555.20 / $937.83	Professional	26	$157.66	$555.20	$937.83
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $560.62 / $2,908.14 / $5,400.50	Professional	TC	$560.62	$2,908.14	$5,400.50
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,249.10 / $2,999.15 / $3,734.32	Professional		$2,249.10	$2,999.15	$3,734.32
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $455.18 / $607.27 / $809.78	Professional	26	$455.18	$607.27	$809.78
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,668.98 / $2,733.67 / $3,251.43	Professional	TC	$1,668.98	$2,733.67	$3,251.43
United Facility/Professional Professional Modifier Low / Median / High Price $581.20 / $1,360.34 / $2,611.10	Professional		$581.20	$1,360.34	$2,611.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $126.63 / $254.30 / $486.63	Professional	26	$126.63	$254.30	$486.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $508.80 / $1,102.93 / $2,289.78	Professional	TC	$508.80	$1,102.93	$2,289.78