Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.00 / $56.00 / $56.05	Facility	26	$40.00	$56.00	$56.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.18 / $139.28 / $266.60	Professional		$101.18	$139.28	$266.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.64 / $27.56 / $75.93	Professional	26	$23.64	$27.56	$75.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.47 / $112.15 / $210.10	Professional	TC	$79.47	$112.15	$210.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.56 / $254.89 / $721.19	Professional		$107.56	$254.89	$721.19
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.81 / $59.59 / $166.02	Professional	26	$25.81	$59.59	$166.02
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $80.48 / $201.39 / $575.13	Professional	TC	$80.48	$201.39	$575.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.29 / $82.14 / $109.17	Facility	26	$70.29	$82.14	$109.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $126.21 / $462.86 / $525.98	Professional		$126.21	$462.86	$525.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.40 / $93.15 / $105.85	Professional	26	$30.40	$93.15	$105.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $95.00 / $369.71 / $420.13	Professional	TC	$95.00	$369.71	$420.13
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $121.12 / $121.12 / $121.12	Facility	26	$121.12	$121.12	$121.12
Medica Facility/Professional Professional Modifier Low / Median / High Price $123.29 / $290.12 / $859.12	Professional		$123.29	$290.12	$859.12
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $30.82 / $70.31 / $211.35	Professional	26	$30.82	$70.31	$211.35
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $94.19 / $218.54 / $689.44	Professional	TC	$94.19	$218.54	$689.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.31 / $103.95 / $249.95	Professional		$55.31	$103.95	$249.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $252.20 / $377.83 / $440.61	Professional		$252.20	$377.83	$440.61
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $121.12 / $121.12	Facility	26	$100.00	$121.12	$121.12
Quartz Facility/Professional Professional Modifier Low / Median / High Price $197.98 / $580.95 / $859.12	Professional		$197.98	$580.95	$859.12
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $43.16 / $135.15 / $211.35	Professional	26	$43.16	$135.15	$211.35
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $155.71 / $452.07 / $689.44	Professional	TC	$155.71	$452.07	$689.44
Security Health Facility/Professional Professional Modifier Low / Median / High Price $215.37 / $749.57 / $824.77	Professional		$215.37	$749.57	$824.77
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $60.19 / $76.16 / $149.40	Professional	26	$60.19	$76.16	$149.40
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $155.18 / $190.86 / $473.58	Professional	TC	$155.18	$190.86	$473.58
United Facility/Professional Professional Modifier Low / Median / High Price $122.34 / $249.81 / $509.20	Professional		$122.34	$249.81	$509.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.50 / $61.84 / $118.46	Professional	26	$29.50	$61.84	$118.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $94.01 / $188.38 / $361.10	Professional	TC	$94.01	$188.38	$361.10