Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $173.39 / $186.66 / $186.66	Facility	26	$173.39	$186.66	$186.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $260.88 / $471.94 / $688.45	Professional		$260.88	$471.94	$688.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.72 / $117.05 / $227.12	Professional	26	$85.72	$117.05	$227.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $170.48 / $341.24 / $561.19	Professional	TC	$170.48	$341.24	$561.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $324.70 / $766.02 / $2,553.02	Professional		$324.70	$766.02	$2,553.02
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $86.70 / $206.14 / $678.08	Professional	26	$86.70	$206.14	$678.08
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $487.06 / $1,215.42 / $3,829.53	Professional	50	$487.06	$1,215.42	$3,829.53
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $238.01 / $566.69 / $1,874.94	Professional	TC	$238.01	$566.69	$1,874.94
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $233.39 / $272.73 / $362.49	Facility	26	$233.39	$272.73	$362.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $419.93 / $1,164.58 / $1,323.40	Professional		$419.93	$1,164.58	$1,323.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $101.93 / $311.86 / $354.39	Professional	26	$101.93	$311.86	$354.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $318.01 / $852.76 / $969.05	Professional	TC	$318.01	$852.76	$969.05
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $833.76 / $833.76 / $833.76	Facility	26	$833.76	$833.76	$833.76
Medica Facility/Professional Professional Modifier Low / Median / High Price $411.92 / $930.26 / $2,878.66	Professional		$411.92	$930.26	$2,878.66
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $107.93 / $244.51 / $561.99	Professional	26	$107.93	$244.51	$561.99
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $300.85 / $709.23 / $2,400.63	Professional	TC	$300.85	$709.23	$2,400.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $80.83 / $188.32 / $483.77	Professional		$80.83	$188.32	$483.77
Quartz Facility/Professional Professional Modifier Low / Median / High Price $638.95 / $778.54 / $1,408.20	Professional		$638.95	$778.54	$1,408.20
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $211.85 / $833.76 / $833.76	Facility	26	$211.85	$833.76	$833.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $490.50 / $1,586.26 / $2,878.66	Professional		$490.50	$1,586.26	$2,878.66
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $131.34 / $462.80 / $561.99	Professional	26	$131.34	$462.80	$561.99
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $359.16 / $1,291.25 / $2,400.63	Professional	TC	$359.16	$1,291.25	$2,400.63
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,031.73 / $1,669.20 / $1,669.20	Professional		$1,031.73	$1,669.20	$1,669.20
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $273.11 / $312.30 / $511.32	Professional	26	$273.11	$312.30	$511.32
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $582.92 / $837.86 / $1,765.07	Professional	TC	$582.92	$837.86	$1,765.07
United Facility/Professional Professional Modifier Low / Median / High Price $397.06 / $858.18 / $1,504.38	Professional		$397.06	$858.18	$1,504.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $101.17 / $216.00 / $405.64	Professional	26	$101.17	$216.00	$405.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $275.70 / $617.59 / $1,144.51	Professional	TC	$275.70	$617.59	$1,144.51