Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.03 / $29.93 / $36.15	Facility	26	$26.03	$29.93	$36.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.64 / $83.58 / $166.88	Professional		$61.64	$83.58	$166.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.47 / $19.23 / $60.02	Professional	26	$15.47	$19.23	$60.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $46.00 / $65.91 / $121.39	Professional	TC	$46.00	$65.91	$121.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.38 / $163.83 / $443.60	Professional		$74.38	$163.83	$443.60
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.80 / $38.79 / $112.72	Professional	26	$16.80	$38.79	$112.72
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $57.32 / $127.37 / $344.89	Professional	TC	$57.32	$127.37	$344.89
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.06 / $52.65 / $69.98	Facility	26	$45.06	$52.65	$69.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $80.09 / $279.32 / $317.41	Professional		$80.09	$279.32	$317.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.78 / $60.87 / $69.18	Professional	26	$19.78	$60.87	$69.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $59.32 / $218.45 / $248.24	Professional	TC	$59.32	$218.45	$248.24
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $77.22 / $77.22 / $77.22	Facility	26	$77.22	$77.22	$77.22
Medica Facility/Professional Professional Modifier Low / Median / High Price $80.29 / $180.61 / $507.76	Professional		$80.29	$180.61	$507.76
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $19.67 / $45.22 / $109.02	Professional	26	$19.67	$45.22	$109.02
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $60.65 / $136.50 / $398.67	Professional	TC	$60.65	$136.50	$398.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.69 / $65.00 / $138.97	Professional		$38.69	$65.00	$138.97
Quartz Facility/Professional Professional Modifier Low / Median / High Price $95.83 / $189.31 / $322.14	Professional		$95.83	$189.31	$322.14
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $41.35 / $77.22 / $77.22	Facility	26	$41.35	$77.22	$77.22
Quartz Facility/Professional Professional Modifier Low / Median / High Price $117.65 / $378.30 / $507.76	Professional		$117.65	$378.30	$507.76
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $26.04 / $90.00 / $109.02	Professional	26	$26.04	$90.00	$109.02
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $92.01 / $288.25 / $398.67	Professional	TC	$92.01	$288.25	$398.67
Security Health Facility/Professional Professional Modifier Low / Median / High Price $131.13 / $497.71 / $497.71	Professional		$131.13	$497.71	$497.71
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $32.78 / $38.56 / $81.94	Professional	26	$32.78	$38.56	$81.94
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $91.06 / $107.13 / $279.97	Professional	TC	$91.06	$107.13	$279.97
United Facility/Professional Professional Modifier Low / Median / High Price $79.76 / $143.75 / $306.42	Professional		$79.76	$143.75	$306.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.97 / $42.23 / $78.89	Professional	26	$18.97	$42.23	$78.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $58.10 / $123.97 / $238.94	Professional	TC	$58.10	$123.97	$238.94