Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.50 / $98.82 / $105.56	Facility	26	$50.50	$98.82	$105.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.54 / $259.42 / $872.99	Professional		$49.54	$259.42	$872.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.99 / $98.82 / $501.50	Professional	26	$44.99	$98.82	$501.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $91.67 / $167.62 / $308.00	Professional	TC	$91.67	$167.62	$308.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $129.71 / $329.94 / $1,014.00	Professional		$129.71	$329.94	$1,014.00
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 $194.56 / $523.86 / $1,521.00	Professional	50	$194.56	$523.86	$1,521.00
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $83.81 / $213.71 / $652.40	Professional	TC	$83.81	$213.71	$652.40
CareSource Facility/Professional Professional Modifier Low / Median / High Price $52.45 / $101.49 / $179.43	Professional		$52.45	$101.49	$179.43
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 $190.11 / $467.27 / $530.99	Professional		$190.11	$467.27	$530.99
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 $122.04 / $301.70 / $342.84	Professional	TC	$122.04	$301.70	$342.84
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $442.24 / $442.24 / $1,042.00	Facility	26	$442.24	$442.24	$1,042.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $179.77 / $424.30 / $1,378.78	Professional		$179.77	$424.30	$1,378.78
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $58.77 / $136.68 / $300.10	Professional	26	$58.77	$136.68	$300.10
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $120.56 / $322.61 / $1,332.00	Professional	TC	$120.56	$322.61	$1,332.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $56.22 / $105.44 / $253.57	Professional		$56.22	$105.44	$253.57
Quartz Facility/Professional Professional Modifier Low / Median / High Price $256.75 / $384.65 / $771.00	Professional		$256.75	$384.65	$771.00
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 $196.80 / $776.73 / $1,378.78	Professional		$196.80	$776.73	$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 $129.59 / $597.79 / $1,332.00	Professional	TC	$129.59	$597.79	$1,332.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $582.21 / $832.63 / $832.63	Professional		$582.21	$832.63	$832.63
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 $303.33 / $450.09 / $904.67	Professional	TC	$303.33	$450.09	$904.67
United Facility/Professional Professional Modifier Low / Median / High Price $159.53 / $392.17 / $745.66	Professional		$159.53	$392.17	$745.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $76.80 / $188.11 / $379.64	Professional	26	$76.80	$188.11	$379.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $103.06 / $251.18 / $563.95	Professional	TC	$103.06	$251.18	$563.95