Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.50 / $57.67 / $57.67	Facility	26	$41.50	$57.67	$57.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.10 / $138.21 / $259.89	Professional		$101.10	$138.21	$259.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.26 / $34.13 / $97.91	Professional	26	$24.26	$34.13	$97.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $75.26 / $110.02 / $207.77	Professional	TC	$75.26	$110.02	$207.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.19 / $258.29 / $732.63	Professional		$109.19	$258.29	$732.63
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.77 / $62.05 / $172.85	Professional	26	$26.77	$62.05	$172.85
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $80.83 / $202.14 / $580.57	Professional	TC	$80.83	$202.14	$580.57
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.89 / $86.35 / $114.76	Facility	26	$73.89	$86.35	$114.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.01 / $451.96 / $513.59	Professional		$125.01	$451.96	$513.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.45 / $97.48 / $110.78	Professional	26	$30.45	$97.48	$110.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $90.57 / $354.48 / $402.81	Professional	TC	$90.57	$354.48	$402.81
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $125.66 / $125.66 / $125.66	Facility	26	$125.66	$125.66	$125.66
Medica Facility/Professional Professional Modifier Low / Median / High Price $125.46 / $285.54 / $873.78	Professional		$125.46	$285.54	$873.78
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $31.38 / $74.44 / $198.13	Professional	26	$31.38	$74.44	$198.13
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $94.50 / $216.54 / $695.99	Professional	TC	$94.50	$216.54	$695.99
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 $243.10 / $323.02 / $442.32	Professional		$243.10	$323.02	$442.32
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $125.66 / $125.66	Facility	26	$100.00	$125.66	$125.66
Quartz Facility/Professional Professional Modifier Low / Median / High Price $191.38 / $592.40 / $873.78	Professional		$191.38	$592.40	$873.78
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $45.17 / $143.15 / $198.13	Professional	26	$45.17	$143.15	$198.13
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $149.29 / $449.25 / $695.99	Professional	TC	$149.29	$449.25	$695.99
Security Health Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $767.81 / $805.30	Professional		$218.78	$767.81	$805.30
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $62.84 / $79.51 / $158.80	Professional	26	$62.84	$79.51	$158.80
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $155.94 / $191.79 / $482.93	Professional	TC	$155.94	$191.79	$482.93
United Facility/Professional Professional Modifier Low / Median / High Price $115.51 / $237.94 / $456.15	Professional		$115.51	$237.94	$456.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.42 / $107.39 / $220.29	Professional	26	$47.42	$107.39	$220.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $94.50 / $189.82 / $346.42	Professional	TC	$94.50	$189.82	$346.42