Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $112.20 / $112.20 / $120.23	Facility	26	$112.20	$112.20	$120.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $275.42 / $537.03	Professional		$169.82	$275.42	$537.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $69.18 / $177.83	Professional	26	$52.48	$69.18	$177.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $213.80 / $371.54	Professional	TC	$138.04	$213.80	$371.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $371.54 / $1,148.15	Professional		$194.98	$371.54	$1,148.15
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $87.10 / $331.13	Professional	26	$56.23	$87.10	$331.13
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $288.40 / $812.83	Professional	TC	$141.25	$288.40	$812.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $151.36 / $177.83 / $281.84	Facility	26	$151.36	$177.83	$281.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $501.19 / $812.83	Professional		$229.09	$501.19	$812.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $120.23 / $234.42	Professional	26	$52.48	$120.23	$234.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $371.54 / $588.84	Professional	TC	$186.21	$371.54	$588.84
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $436.52 / $691.83	Professional		$363.08	$436.52	$691.83
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $125.89 / $158.49	Professional	26	$104.71	$125.89	$158.49
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $309.03 / $537.03	Professional	TC	$263.03	$309.03	$537.03
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $537.03 / $537.03 / $537.03	Facility	26	$537.03	$537.03	$537.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $537.03 / $2,089.30	Professional		$269.15	$537.03	$2,089.30
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $125.89 / $380.19	Professional	26	$61.66	$125.89	$380.19
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $416.87 / $1,737.80	Professional	TC	$199.53	$416.87	$1,737.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $407.38	Professional		$32.36	$33.11	$407.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $501.19 / $1,148.15	Professional		$257.04	$501.19	$1,148.15
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $131.83 / $524.81 / $524.81	Facility	26	$131.83	$524.81	$524.81
Quartz Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $1,202.26 / $2,089.30	Professional		$309.03	$1,202.26	$2,089.30
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $302.00 / $380.19	Professional	26	$72.44	$302.00	$380.19
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $1,000.00 / $1,819.70	Professional	TC	$223.87	$1,000.00	$1,819.70
Security Health Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,122.02 / $1,659.59	Professional		$758.58	$1,122.02	$1,659.59
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $199.53 / $213.80 / $269.15	Professional	26	$199.53	$213.80	$269.15
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $501.19 / $691.83 / $870.96	Professional	TC	$501.19	$691.83	$870.96
United Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $416.87 / $870.96	Professional		$239.88	$416.87	$870.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $95.50 / $218.78	Professional	26	$61.66	$95.50	$218.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $323.59 / $691.83	Professional	TC	$173.78	$323.59	$691.83