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 / $120.65	Facility	26	$112.29	$120.65	$120.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $226.45 / $413.51 / $670.41	Professional		$226.45	$413.51	$670.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.43 / $74.25 / $171.72	Professional	26	$55.43	$74.25	$171.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $168.97 / $329.29 / $382.16	Professional	TC	$168.97	$329.29	$382.16
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $255.63 / $601.04 / $1,979.28	Professional		$255.63	$601.04	$1,979.28
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 $199.49 / $471.56 / $1,526.41	Professional	TC	$199.49	$471.56	$1,526.41
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $150.49 / $175.86 / $233.73	Facility	26	$150.49	$175.86	$233.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $348.58 / $912.38 / $1,036.80	Professional		$348.58	$912.38	$1,036.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.91 / $201.12 / $228.55	Professional	26	$65.91	$201.12	$228.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $269.49 / $711.26 / $808.25	Professional	TC	$269.49	$711.26	$808.25
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $537.20 / $537.20 / $537.20	Facility	26	$537.20	$537.20	$537.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $315.33 / $723.85 / $2,195.67	Professional		$315.33	$723.85	$2,195.67
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $68.64 / $158.87 / $439.20	Professional	26	$68.64	$158.87	$439.20
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $243.17 / $571.98 / $1,890.23	Professional	TC	$243.17	$571.98	$1,890.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.40 / $182.56 / $440.03	Professional		$58.40	$182.56	$440.03
Quartz Facility/Professional Professional Modifier Low / Median / High Price $495.30 / $725.42 / $1,217.41	Professional		$495.30	$725.42	$1,217.41
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $136.63 / $537.20 / $537.20	Facility	26	$136.63	$537.20	$537.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $384.28 / $1,203.88 / $2,195.67	Professional		$384.28	$1,203.88	$2,195.67
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $84.71 / $300.70 / $439.20	Professional	26	$84.71	$300.70	$439.20
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $299.57 / $1,014.39 / $1,890.23	Professional	TC	$299.57	$1,014.39	$1,890.23
Security Health Facility/Professional Professional Modifier Low / Median / High Price $841.30 / $1,473.27 / $1,473.27	Professional		$841.30	$1,473.27	$1,473.27
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 $640.01 / $787.15 / $1,394.98	Professional	TC	$640.01	$787.15	$1,394.98
United Facility/Professional Professional Modifier Low / Median / High Price $304.13 / $663.31 / $1,307.96	Professional		$304.13	$663.31	$1,307.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $65.65 / $146.96 / $299.33	Professional	26	$65.65	$146.96	$299.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $232.51 / $492.72 / $913.33	Professional	TC	$232.51	$492.72	$913.33