Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $117.18 / $125.21 / $125.21	Facility	26	$117.18	$125.21	$125.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $198.17 / $342.37 / $459.07	Professional		$198.17	$342.37	$459.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.89 / $67.40 / $189.16	Professional	26	$57.89	$67.40	$189.16
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $138.16 / $279.86 / $325.77	Professional	TC	$138.16	$279.86	$325.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $198.52 / $506.23 / $1,554.69	Professional		$198.52	$506.23	$1,554.69
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.59 / $139.31 / $458.71	Professional	26	$58.59	$139.31	$458.71
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $139.93 / $356.82 / $1,095.96	Professional	TC	$139.93	$356.82	$1,095.96
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $156.79 / $183.23 / $243.52	Facility	26	$156.79	$183.23	$243.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $287.63 / $713.77 / $811.10	Professional		$287.63	$713.77	$811.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.67 / $209.99 / $238.63	Professional	26	$69.67	$209.99	$238.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $201.37 / $503.75 / $572.44	Professional	TC	$201.37	$503.75	$572.44
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $561.91 / $561.91 / $561.91	Facility	26	$561.91	$561.91	$561.91
Medica Facility/Professional Professional Modifier Low / Median / High Price $265.99 / $667.64 / $2,293.84	Professional		$265.99	$667.64	$2,293.84
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $71.30 / $164.55 / $523.40	Professional	26	$71.30	$164.55	$523.40
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $191.24 / $517.95 / $2,412.00	Professional	TC	$191.24	$517.95	$2,412.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.40 / $157.40 / $378.01	Professional		$58.40	$157.40	$378.01
Quartz Facility/Professional Professional Modifier Low / Median / High Price $389.35 / $583.30 / $1,141.58	Professional		$389.35	$583.30	$1,141.58
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $142.65 / $561.91 / $561.91	Facility	26	$142.65	$561.91	$561.91
Quartz Facility/Professional Professional Modifier Low / Median / High Price $300.62 / $1,258.34 / $2,293.84	Professional		$300.62	$1,258.34	$2,293.84
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $88.45 / $311.45 / $523.40	Professional	26	$88.45	$311.45	$523.40
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $214.13 / $1,059.78 / $2,412.00	Professional	TC	$214.13	$1,059.78	$2,412.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $741.58 / $1,271.82 / $1,271.82	Professional		$741.58	$1,271.82	$1,271.82
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $209.56 / $218.48 / $340.54	Professional	26	$209.56	$218.48	$340.54
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $506.46 / $715.59 / $1,421.29	Professional	TC	$506.46	$715.59	$1,421.29
United Facility/Professional Professional Modifier Low / Median / High Price $243.26 / $569.05 / $1,103.29	Professional		$243.26	$569.05	$1,103.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.98 / $150.12 / $310.04	Professional	26	$67.98	$150.12	$310.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $174.19 / $414.56 / $873.98	Professional	TC	$174.19	$414.56	$873.98