Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $164.72 / $177.32 / $177.32	Facility	26	$164.72	$177.32	$177.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $256.10 / $467.34 / $745.98	Professional		$256.10	$467.34	$745.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.27 / $109.67 / $449.74	Professional	26	$81.27	$109.67	$449.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $168.49 / $341.24 / $560.94	Professional	TC	$168.49	$341.24	$560.94
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $306.20 / $713.38 / $2,348.63	Professional		$306.20	$713.38	$2,348.63
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $82.36 / $195.82 / $646.50	Professional	26	$82.36	$195.82	$646.50
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $220.83 / $522.59 / $1,683.77	Professional	TC	$220.83	$522.59	$1,683.77
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $221.68 / $259.05 / $344.29	Facility	26	$221.68	$259.05	$344.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $417.41 / $1,098.05 / $1,247.79	Professional		$417.41	$1,098.05	$1,247.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.32 / $296.14 / $336.53	Professional	26	$97.32	$296.14	$336.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $301.55 / $801.94 / $911.30	Professional	TC	$301.55	$801.94	$911.30
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $792.40 / $792.40 / $792.40	Facility	26	$792.40	$792.40	$792.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $374.18 / $848.69 / $3,081.89	Professional		$374.18	$848.69	$3,081.89
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $103.16 / $233.23 / $554.78	Professional	26	$103.16	$233.23	$554.78
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $268.23 / $669.98 / $2,625.91	Professional	TC	$268.23	$669.98	$2,625.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $80.83 / $188.32 / $487.55	Professional		$80.83	$188.32	$487.55
Quartz Facility/Professional Professional Modifier Low / Median / High Price $602.54 / $845.54 / $1,316.34	Professional		$602.54	$845.54	$1,316.34
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $201.18 / $792.40 / $792.40	Facility	26	$201.18	$792.40	$792.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $462.48 / $1,695.18 / $3,081.89	Professional		$462.48	$1,695.18	$3,081.89
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $124.72 / $441.45 / $554.78	Professional	26	$124.72	$441.45	$554.78
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $337.76 / $1,412.66 / $2,625.91	Professional	TC	$337.76	$1,412.66	$2,625.91
Security Health Facility/Professional Professional Modifier Low / Median / High Price $990.13 / $1,640.47 / $1,640.47	Professional		$990.13	$1,640.47	$1,640.47
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $273.11 / $298.10 / $487.28	Professional	26	$273.11	$298.10	$487.28
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $692.03 / $758.63 / $1,763.20	Professional	TC	$692.03	$758.63	$1,763.20
United Facility/Professional Professional Modifier Low / Median / High Price $346.59 / $779.55 / $1,552.05	Professional		$346.59	$779.55	$1,552.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $96.42 / $213.71 / $386.93	Professional	26	$96.42	$213.71	$386.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $245.79 / $576.87 / $1,116.03	Professional	TC	$245.79	$576.87	$1,116.03