Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $106.94 / $114.89 / $114.89	Facility	26	$106.94	$114.89	$114.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $201.80 / $335.06 / $586.50	Professional		$201.80	$335.06	$586.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.34 / $71.81 / $255.77	Professional	26	$52.34	$71.81	$255.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $147.05 / $272.63 / $419.56	Professional	TC	$147.05	$272.63	$419.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $202.41 / $480.73 / $1,590.07	Professional		$202.41	$480.73	$1,590.07
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.47 / $127.13 / $416.91	Professional	26	$53.47	$127.13	$416.91
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $148.94 / $357.44 / $1,173.18	Professional	TC	$148.94	$357.44	$1,173.18
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $144.18 / $168.48 / $223.93	Facility	26	$144.18	$168.48	$223.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $286.20 / $724.47 / $823.26	Professional		$286.20	$724.47	$823.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.24 / $192.62 / $218.89	Professional	26	$63.24	$192.62	$218.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $207.87 / $531.89 / $604.42	Professional	TC	$207.87	$531.89	$604.42
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $514.88 / $514.88 / $514.88	Facility	26	$514.88	$514.88	$514.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $258.22 / $575.66 / $1,627.19	Professional		$258.22	$575.66	$1,627.19
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $65.42 / $150.61 / $345.18	Professional	26	$65.42	$150.61	$345.18
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $189.61 / $431.40 / $1,330.47	Professional	TC	$189.61	$431.40	$1,330.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.40 / $157.40 / $377.23	Professional		$58.40	$157.40	$377.23
Quartz Facility/Professional Professional Modifier Low / Median / High Price $395.20 / $592.07 / $1,036.30	Professional		$395.20	$592.07	$1,036.30
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $130.85 / $514.88 / $514.88	Facility	26	$130.85	$514.88	$514.88
Quartz Facility/Professional Professional Modifier Low / Median / High Price $305.14 / $1,075.90 / $1,627.19	Professional		$305.14	$1,075.90	$1,627.19
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $81.12 / $285.85 / $345.18	Professional	26	$81.12	$285.85	$345.18
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $224.02 / $790.00 / $1,330.47	Professional	TC	$224.02	$790.00	$1,330.47
Security Health Facility/Professional Professional Modifier Low / Median / High Price $719.72 / $1,290.95 / $1,290.95	Professional		$719.72	$1,290.95	$1,290.95
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $191.82 / $197.24 / $313.39	Professional	26	$191.82	$197.24	$313.39
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $527.90 / $591.73 / $1,126.33	Professional	TC	$527.90	$591.73	$1,126.33
United Facility/Professional Professional Modifier Low / Median / High Price $246.86 / $535.77 / $1,071.04	Professional		$246.86	$535.77	$1,071.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $62.37 / $131.33 / $277.00	Professional	26	$62.37	$131.33	$277.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $181.27 / $395.02 / $692.48	Professional	TC	$181.27	$395.02	$692.48