Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.80 / $98.82 / $105.56	Facility	26	$91.80	$98.82	$105.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $147.16 / $294.83 / $1,552.30	Professional		$147.16	$294.83	$1,552.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.95 / $91.80 / $463.60	Professional	26	$46.95	$91.80	$463.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $110.93 / $203.03 / $379.20	Professional	TC	$110.93	$203.03	$379.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $162.55 / $386.08 / $1,283.17	Professional		$162.55	$386.08	$1,283.17
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.90 / $109.13 / $361.60	Professional	26	$45.90	$109.13	$361.60
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $243.82 / $598.72 / $1,924.75	Professional	50	$243.82	$598.72	$1,924.75
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $116.64 / $279.79 / $921.59	Professional	TC	$116.64	$279.79	$921.59
CareSource Facility/Professional Professional Modifier Low / Median / High Price $52.45 / $138.94 / $221.27	Professional		$52.45	$138.94	$221.27
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $124.35 / $145.32 / $193.14	Facility	26	$124.35	$145.32	$193.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $234.90 / $582.16 / $661.55	Professional		$234.90	$582.16	$661.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.39 / $165.57 / $188.15	Professional	26	$59.39	$165.57	$188.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $162.66 / $416.59 / $473.40	Professional	TC	$162.66	$416.59	$473.40
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $442.24 / $442.24 / $442.24	Facility	26	$442.24	$442.24	$442.24
Medica Facility/Professional Professional Modifier Low / Median / High Price $207.31 / $468.18 / $1,378.78	Professional		$207.31	$468.18	$1,378.78
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $58.76 / $133.71 / $300.10	Professional	26	$58.76	$133.71	$300.10
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $148.10 / $356.30 / $1,103.98	Professional	TC	$148.10	$356.30	$1,103.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $56.22 / $130.87 / $309.23	Professional		$56.22	$130.87	$309.23
Quartz Facility/Professional Professional Modifier Low / Median / High Price $317.85 / $476.19 / $771.29	Professional		$317.85	$476.19	$771.29
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $112.48 / $442.24 / $442.24	Facility	26	$112.48	$442.24	$442.24
Quartz Facility/Professional Professional Modifier Low / Median / High Price $245.19 / $778.15 / $1,378.78	Professional		$245.19	$778.15	$1,378.78
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $69.73 / $246.70 / $300.10	Professional	26	$69.73	$246.70	$300.10
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $175.46 / $596.66 / $1,103.98	Professional	TC	$175.46	$596.66	$1,103.98
Security Health Facility/Professional Professional Modifier Low / Median / High Price $581.05 / $962.09 / $962.09	Professional		$581.05	$962.09	$962.09
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $165.27 / $182.07 / $270.81	Professional	26	$165.27	$182.07	$270.81
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $415.80 / $511.39 / $900.92	Professional	TC	$415.80	$511.39	$900.92
United Facility/Professional Professional Modifier Low / Median / High Price $193.18 / $416.35 / $757.12	Professional		$193.18	$416.35	$757.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.87 / $115.31 / $222.58	Professional	26	$53.87	$115.31	$222.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $135.68 / $308.55 / $576.87	Professional	TC	$135.68	$308.55	$576.87