Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $111.65 / $119.95 / $119.95	Facility	26	$111.65	$119.95	$119.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $195.50 / $391.51 / $622.37	Professional		$195.50	$391.51	$622.37
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.43 / $73.97 / $159.93	Professional	26	$55.43	$73.97	$159.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $138.16 / $279.86 / $541.57	Professional	TC	$138.16	$279.86	$541.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $195.75 / $484.55 / $1,532.99	Professional		$195.75	$484.55	$1,532.99
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $55.82 / $132.72 / $439.54	Professional	26	$55.82	$132.72	$439.54
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $139.93 / $356.82 / $1,093.45	Professional	TC	$139.93	$356.82	$1,093.45
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $150.49 / $175.86 / $233.73	Facility	26	$150.49	$175.86	$233.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $285.44 / $704.86 / $800.98	Professional		$285.44	$704.86	$800.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.91 / $201.12 / $228.55	Professional	26	$65.91	$201.12	$228.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $202.81 / $503.75 / $572.44	Professional	TC	$202.81	$503.75	$572.44
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $537.20 / $537.20 / $537.20	Facility	26	$537.20	$537.20	$537.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $270.41 / $621.71 / $2,082.64	Professional		$270.41	$621.71	$2,082.64
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $68.55 / $157.97 / $381.41	Professional	26	$68.55	$157.97	$381.41
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $198.65 / $518.09 / $1,754.89	Professional	TC	$198.65	$518.09	$1,754.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.40 / $157.40 / $377.33	Professional		$58.40	$157.40	$377.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $386.10 / $578.44 / $1,151.27	Professional		$386.10	$578.44	$1,151.27
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $136.63 / $537.20 / $537.20	Facility	26	$136.63	$537.20	$537.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $303.20 / $1,189.44 / $2,082.64	Professional		$303.20	$1,189.44	$2,082.64
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $84.71 / $299.00 / $381.41	Professional	26	$84.71	$299.00	$381.41
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $212.17 / $989.07 / $1,754.89	Professional	TC	$212.17	$989.07	$1,754.89
Security Health Facility/Professional Professional Modifier Low / Median / High Price $753.02 / $1,256.02 / $1,256.02	Professional		$753.02	$1,256.02	$1,256.02
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $201.29 / $212.42 / $328.88	Professional	26	$201.29	$212.42	$328.88
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $506.46 / $684.62 / $1,500.19	Professional	TC	$506.46	$684.62	$1,500.19
United Facility/Professional Professional Modifier Low / Median / High Price $240.07 / $563.35 / $1,007.81	Professional		$240.07	$563.35	$1,007.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $80.00 / $222.76 / $460.07	Professional	26	$80.00	$222.76	$460.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $174.68 / $430.61 / $823.96	Professional	TC	$174.68	$430.61	$823.96