Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.79 / $24.71 / $24.71	Facility	26	$17.79	$24.71	$24.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $50.31 / $174.07	Professional		$38.90	$50.31	$174.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.57 / $12.13 / $41.79	Professional	26	$9.57	$12.13	$41.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.96 / $36.36 / $66.86	Professional	TC	$27.96	$36.36	$66.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.84 / $87.52 / $243.21	Professional		$40.84	$87.52	$243.21
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.28 / $24.30 / $70.40	Professional	26	$11.28	$24.30	$70.40
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.45 / $63.59 / $178.74	Professional	TC	$29.45	$63.59	$178.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.64 / $35.79 / $47.59	Facility	26	$30.64	$35.79	$47.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.65 / $156.88 / $178.28	Professional		$51.65	$156.88	$178.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.38 / $41.59 / $47.26	Professional	26	$12.38	$41.59	$47.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.86 / $115.30 / $131.03	Professional	TC	$39.86	$115.30	$131.03
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $103.00 / $103.00 / $103.00	Facility	26	$103.00	$103.00	$103.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $46.12 / $107.82 / $286.68	Professional		$46.12	$107.82	$286.68
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.09 / $30.70 / $107.32	Professional	26	$13.09	$30.70	$107.32
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $32.76 / $77.20 / $267.00	Professional	TC	$32.76	$77.20	$267.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.34 / $44.03 / $77.04	Professional		$19.34	$44.03	$77.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $130.49 / $211.37	Professional		$87.10	$130.49	$211.37
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $103.00 / $103.00	Facility	26	$100.00	$103.00	$103.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $72.68 / $207.25 / $286.68	Professional		$72.68	$207.25	$286.68
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $18.01 / $61.10 / $107.32	Professional	26	$18.01	$61.10	$107.32
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $50.61 / $146.15 / $267.00	Professional	TC	$50.61	$146.15	$267.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $83.87 / $254.20 / $279.52	Professional		$83.87	$254.20	$279.52
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $24.02 / $31.01 / $59.15	Professional	26	$24.02	$31.01	$59.15
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $59.85 / $84.14 / $192.68	Professional	TC	$59.85	$84.14	$192.68
United Facility/Professional Professional Modifier Low / Median / High Price $44.39 / $89.12 / $181.65	Professional		$44.39	$89.12	$181.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.29 / $26.28 / $49.20	Professional	26	$12.29	$26.28	$49.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.04 / $67.33 / $128.26	Professional	TC	$31.04	$67.33	$128.26