Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $112.20 / $112.20 / $120.23	Facility	26	$112.20	$112.20	$120.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $288.40 / $602.56	Professional		$218.78	$288.40	$602.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $79.43 / $165.96	Professional	26	$53.70	$79.43	$165.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $218.78 / $416.87	Professional	TC	$162.18	$218.78	$416.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $398.11 / $1,412.54	Professional		$257.04	$398.11	$1,412.54
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $87.10 / $331.13	Professional	26	$56.23	$87.10	$331.13
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $309.03 / $1,096.48	Professional	TC	$199.53	$309.03	$1,096.48
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $151.36 / $177.83 / $281.84	Facility	26	$151.36	$177.83	$281.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $562.34 / $1,047.13	Professional		$263.03	$562.34	$1,047.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $120.23 / $234.42	Professional	26	$52.48	$120.23	$234.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $446.68 / $831.76	Professional	TC	$199.53	$446.68	$831.76
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $562.34 / $758.58	Professional		$467.74	$562.34	$758.58
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $128.82 / $173.78	Professional	26	$104.71	$128.82	$173.78
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $363.08 / $436.52 / $588.84	Professional	TC	$363.08	$436.52	$588.84
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $537.03 / $537.03 / $537.03	Facility	26	$537.03	$537.03	$537.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $616.60 / $2,187.76	Professional		$316.23	$616.60	$2,187.76
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $128.82 / $436.52	Professional	26	$63.10	$128.82	$436.52
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $489.78 / $1,905.46	Professional	TC	$245.47	$489.78	$1,905.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $389.05	Professional		$32.36	$33.11	$389.05
Quartz Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $630.96 / $1,230.27	Professional		$331.13	$630.96	$1,230.27
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $134.90 / $524.81 / $524.81	Facility	26	$134.90	$524.81	$524.81
Quartz Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $1,258.93 / $2,238.72	Professional		$363.08	$1,258.93	$2,238.72
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $302.00 / $436.52	Professional	26	$72.44	$302.00	$436.52
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $1,071.52 / $1,949.84	Professional	TC	$275.42	$1,071.52	$1,949.84
Security Health Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $1,258.93 / $1,737.80	Professional		$831.76	$1,258.93	$1,737.80
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $199.53 / $213.80 / $275.42	Professional	26	$199.53	$213.80	$275.42
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $630.96 / $758.58 / $1,000.00	Professional	TC	$630.96	$758.58	$1,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $457.09 / $977.24	Professional		$275.42	$457.09	$977.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $95.50 / $218.78	Professional	26	$61.66	$95.50	$218.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $354.81 / $776.25	Professional	TC	$213.80	$354.81	$776.25