Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $178.04 / $178.04 / $198.48	Facility	26	$178.04	$178.04	$198.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $356.22 / $494.18 / $1,069.00	Professional		$356.22	$494.18	$1,069.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $86.71 / $140.00 / $264.06	Professional	26	$86.71	$140.00	$264.06
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $266.52 / $348.53 / $713.58	Professional	TC	$266.52	$348.53	$713.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $337.77 / $818.17 / $2,659.97	Professional		$337.77	$818.17	$2,659.97
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $82.70 / $196.63 / $646.65	Professional	26	$82.70	$196.63	$646.65
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $506.65 / $1,291.96 / $3,989.95	Professional	50	$506.65	$1,291.96	$3,989.95
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $255.07 / $627.34 / $2,013.31	Professional	TC	$255.07	$627.34	$2,013.31
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $222.58 / $260.10 / $345.69	Facility	26	$222.58	$260.10	$345.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $483.60 / $1,213.42 / $1,378.89	Professional		$483.60	$1,213.42	$1,378.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $99.02 / $297.35 / $337.90	Professional	26	$99.02	$297.35	$337.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $368.68 / $916.07 / $1,040.99	Professional	TC	$368.68	$916.07	$1,040.99
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $795.52 / $795.52 / $795.52	Facility	26	$795.52	$795.52	$795.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $447.91 / $986.01 / $3,018.44	Professional		$447.91	$986.01	$3,018.44
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $101.06 / $227.92 / $850.86	Professional	26	$101.06	$227.92	$850.86
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $341.53 / $771.29 / $2,546.60	Professional	TC	$341.53	$771.29	$2,546.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $80.83 / $230.51 / $615.87	Professional		$80.83	$230.51	$615.87
Quartz Facility/Professional Professional Modifier Low / Median / High Price $666.25 / $998.15 / $1,467.25	Professional		$666.25	$998.15	$1,467.25
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $202.00 / $795.52 / $795.52	Facility	26	$202.00	$795.52	$795.52
Quartz Facility/Professional Professional Modifier Low / Median / High Price $511.06 / $1,866.30 / $3,018.44	Professional		$511.06	$1,866.30	$3,018.44
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $125.24 / $443.25 / $850.86	Professional	26	$125.24	$443.25	$850.86
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $385.82 / $1,560.96 / $2,546.60	Professional	TC	$385.82	$1,560.96	$2,546.60
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,775.18 / $2,162.17 / $2,642.90	Professional		$1,775.18	$2,162.17	$2,642.90
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $333.80 / $487.10 / $645.00	Professional	26	$333.80	$487.10	$645.00
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,356.60 / $1,823.84 / $2,169.28	Professional	TC	$1,356.60	$1,823.84	$2,169.28
United Facility/Professional Professional Modifier Low / Median / High Price $407.97 / $899.56 / $2,021.98	Professional		$407.97	$899.56	$2,021.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $92.03 / $202.12 / $371.43	Professional	26	$92.03	$202.12	$371.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $312.95 / $692.00 / $1,247.30	Professional	TC	$312.95	$692.00	$1,247.30