Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $171.02 / $171.02 / $191.93	Facility	26	$171.02	$171.02	$191.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $286.69 / $484.91 / $859.27	Professional		$286.69	$484.91	$859.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.93 / $140.00 / $216.76	Professional	26	$83.93	$140.00	$216.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $199.99 / $335.00 / $459.45	Professional	TC	$199.99	$335.00	$459.45
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $271.41 / $692.09 / $2,146.28	Professional		$271.41	$692.09	$2,146.28
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $79.97 / $190.15 / $625.13	Professional	26	$79.97	$190.15	$625.13
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $191.44 / $488.17 / $1,521.15	Professional	TC	$191.44	$488.17	$1,521.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $214.47 / $250.62 / $333.10	Facility	26	$214.47	$250.62	$333.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $392.28 / $970.61 / $1,102.96	Professional		$392.28	$970.61	$1,102.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $92.43 / $285.91 / $324.89	Professional	26	$92.43	$285.91	$324.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $274.47 / $684.70 / $778.06	Professional	TC	$274.47	$684.70	$778.06
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $764.32 / $764.32 / $764.32	Facility	26	$764.32	$764.32	$764.32
Medica Facility/Professional Professional Modifier Low / Median / High Price $390.04 / $943.38 / $3,389.77	Professional		$390.04	$943.38	$3,389.77
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $102.48 / $231.43 / $657.14	Professional	26	$102.48	$231.43	$657.14
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $279.02 / $697.55 / $2,953.83	Professional	TC	$279.02	$697.55	$2,953.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $80.47 / $190.52 / $494.25	Professional		$80.47	$190.52	$494.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $531.04 / $795.59 / $1,928.34	Professional		$531.04	$795.59	$1,928.34
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $194.23 / $764.32 / $764.32	Facility	26	$194.23	$764.32	$764.32
Quartz Facility/Professional Professional Modifier Low / Median / High Price $417.68 / $1,858.58 / $3,389.77	Professional		$417.68	$1,858.58	$3,389.77
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $120.42 / $427.00 / $657.14	Professional	26	$120.42	$427.00	$657.14
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $292.08 / $1,588.54 / $2,953.83	Professional	TC	$292.08	$1,588.54	$2,953.83
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,729.53 / $1,729.53 / $2,655.33	Professional		$1,729.53	$1,729.53	$2,655.33
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $364.14 / $467.59 / $621.66	Professional	26	$364.14	$467.59	$621.66
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,075.94 / $1,896.79 / $2,256.04	Professional	TC	$1,075.94	$1,896.79	$2,256.04
United Facility/Professional Professional Modifier Low / Median / High Price $360.04 / $792.56 / $1,684.10	Professional		$360.04	$792.56	$1,684.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $94.26 / $213.50 / $374.27	Professional	26	$94.26	$213.50	$374.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $244.67 / $579.50 / $1,319.52	Professional	TC	$244.67	$579.50	$1,319.52