Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $112.29 / $120.65 / $129.13	Facility	26	$112.29	$120.65	$129.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.00 / $333.69 / $520.83	Professional		$171.00	$333.69	$520.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.68 / $74.25 / $287.00	Professional	26	$55.68	$74.25	$287.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $119.70 / $225.78 / $440.62	Professional	TC	$119.70	$225.78	$440.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.03 / $431.04 / $1,325.91	Professional		$169.03	$431.04	$1,325.91
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.15 / $133.50 / $439.54	Professional	26	$56.15	$133.50	$439.54
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $112.89 / $287.86 / $886.37	Professional	TC	$112.89	$287.86	$886.37
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $151.38 / $176.91 / $235.13	Facility	26	$151.38	$176.91	$235.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $246.58 / $608.74 / $691.75	Professional		$246.58	$608.74	$691.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.91 / $202.30 / $229.89	Professional	26	$65.91	$202.30	$229.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $163.47 / $406.44 / $461.86	Professional	TC	$163.47	$406.44	$461.86
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $540.32 / $540.32 / $540.32	Facility	26	$540.32	$540.32	$540.32
Medica Facility/Professional Professional Modifier Low / Median / High Price $226.84 / $569.36 / $1,882.38	Professional		$226.84	$569.36	$1,882.38
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $68.64 / $158.87 / $434.24	Professional	26	$68.64	$158.87	$434.24
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $154.66 / $418.89 / $1,576.92	Professional	TC	$154.66	$418.89	$1,576.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $56.22 / $130.87 / $312.33	Professional		$56.22	$130.87	$312.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $333.45 / $499.56 / $1,029.70	Professional		$333.45	$499.56	$1,029.70
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $137.43 / $540.32 / $540.32	Facility	26	$137.43	$540.32	$540.32
Quartz Facility/Professional Professional Modifier Low / Median / High Price $256.39 / $1,035.95 / $1,882.38	Professional		$256.39	$1,035.95	$1,882.38
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $85.20 / $300.70 / $434.24	Professional	26	$85.20	$300.70	$434.24
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $171.19 / $846.45 / $1,576.92	Professional	TC	$171.19	$846.45	$1,576.92
Security Health Facility/Professional Professional Modifier Low / Median / High Price $628.57 / $1,084.69 / $1,084.69	Professional		$628.57	$1,084.69	$1,084.69
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $201.29 / $212.42 / $328.88	Professional	26	$201.29	$212.42	$328.88
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $408.63 / $538.20 / $1,143.25	Professional	TC	$408.63	$538.20	$1,143.25
United Facility/Professional Professional Modifier Low / Median / High Price $207.31 / $459.63 / $914.08	Professional		$207.31	$459.63	$914.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $65.73 / $140.49 / $299.33	Professional	26	$65.73	$140.49	$299.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $139.01 / $340.48 / $695.20	Professional	TC	$139.01	$340.48	$695.20