Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $112.50 / $120.89 / $129.37	Facility	26	$112.50	$120.89	$129.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.00 / $340.21 / $571.20	Professional		$171.00	$340.21	$571.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.74 / $80.79 / $322.75	Professional	26	$55.74	$80.79	$322.75
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $119.70 / $227.71 / $440.62	Professional	TC	$119.70	$227.71	$440.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $170.11 / $422.75 / $1,335.97	Professional		$170.11	$422.75	$1,335.97
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.25 / $133.75 / $442.06	Professional	26	$56.25	$133.75	$442.06
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $113.85 / $290.33 / $893.91	Professional	TC	$113.85	$290.33	$893.91
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 $248.66 / $612.67 / $696.23	Professional		$248.66	$612.67	$696.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.91 / $202.71 / $230.35	Professional	26	$65.91	$202.71	$230.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $165.39 / $409.97 / $465.88	Professional	TC	$165.39	$409.97	$465.88
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $542.79 / $542.79 / $542.79	Facility	26	$542.79	$542.79	$542.79
Medica Facility/Professional Professional Modifier Low / Median / High Price $228.48 / $573.48 / $1,884.77	Professional		$228.48	$573.48	$1,884.77
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $68.63 / $158.87 / $434.24	Professional	26	$68.63	$158.87	$434.24
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $156.31 / $423.34 / $1,950.00	Professional	TC	$156.31	$423.34	$1,950.00
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 $336.70 / $504.43 / $1,029.70	Professional		$336.70	$504.43	$1,029.70
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $137.69 / $542.79 / $542.79	Facility	26	$137.69	$542.79	$542.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $258.04 / $1,035.95 / $1,884.77	Professional		$258.04	$1,035.95	$1,884.77
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $85.37 / $300.70 / $434.24	Professional	26	$85.37	$300.70	$434.24
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $172.67 / $846.45 / $1,950.00	Professional	TC	$172.67	$846.45	$1,950.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $631.48 / $1,091.69 / $1,091.69	Professional		$631.48	$1,091.69	$1,091.69
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $202.43 / $212.42 / $328.88	Professional	26	$202.43	$212.42	$328.88
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $412.18 / $540.49 / $1,148.89	Professional	TC	$412.18	$540.49	$1,148.89
United Facility/Professional Professional Modifier Low / Median / High Price $208.91 / $495.28 / $882.56	Professional		$208.91	$495.28	$882.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $68.55 / $145.96 / $263.57	Professional	26	$68.55	$145.96	$263.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $140.21 / $344.24 / $695.20	Professional	TC	$140.21	$344.24	$695.20