Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $166.68 / $179.44 / $179.44	Facility	26	$166.68	$179.44	$179.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $257.08 / $476.23 / $927.00	Professional		$257.08	$476.23	$927.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.39 / $130.38 / $969.00	Professional	26	$85.39	$130.38	$969.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $170.12 / $341.24 / $561.76	Professional	TC	$170.12	$341.24	$561.76
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $307.83 / $713.43 / $2,353.92	Professional		$307.83	$713.43	$2,353.92
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $83.34 / $198.17 / $651.69	Professional	26	$83.34	$198.17	$651.69
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $221.17 / $521.11 / $1,681.19	Professional	TC	$221.17	$521.11	$1,681.19
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $224.38 / $262.20 / $348.49	Facility	26	$224.38	$262.20	$348.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $417.88 / $1,102.79 / $1,253.18	Professional		$417.88	$1,102.79	$1,253.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $101.93 / $299.72 / $340.59	Professional	26	$101.93	$299.72	$340.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $301.12 / $803.12 / $912.64	Professional	TC	$301.12	$803.12	$912.64
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $801.92 / $801.92 / $801.92	Facility	26	$801.92	$801.92	$801.92
Medica Facility/Professional Professional Modifier Low / Median / High Price $375.04 / $846.95 / $3,101.53	Professional		$375.04	$846.95	$3,101.53
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $106.39 / $237.88 / $660.44	Professional	26	$106.39	$237.88	$660.44
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $267.83 / $672.28 / $2,625.91	Professional	TC	$267.83	$672.28	$2,625.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $80.83 / $188.32 / $487.55	Professional		$80.83	$188.32	$487.55
Quartz Facility/Professional Professional Modifier Low / Median / High Price $605.15 / $845.54 / $1,323.51	Professional		$605.15	$845.54	$1,323.51
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $203.60 / $801.92 / $801.92	Facility	26	$203.60	$801.92	$801.92
Quartz Facility/Professional Professional Modifier Low / Median / High Price $464.48 / $1,707.67 / $3,101.53	Professional		$464.48	$1,707.67	$3,101.53
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $126.23 / $446.65 / $660.44	Professional	26	$126.23	$446.65	$660.44
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $338.25 / $1,412.66 / $2,625.91	Professional	TC	$338.25	$1,412.66	$2,625.91
Security Health Facility/Professional Professional Modifier Low / Median / High Price $994.21 / $1,646.80 / $1,646.80	Professional		$994.21	$1,646.80	$1,646.80
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $273.11 / $298.75 / $512.40	Professional	26	$273.11	$298.75	$512.40
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $695.46 / $758.63 / $1,766.93	Professional	TC	$695.46	$758.63	$1,766.93
United Facility/Professional Professional Modifier Low / Median / High Price $362.47 / $812.97 / $1,555.59	Professional		$362.47	$812.97	$1,555.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $97.53 / $216.89 / $501.42	Professional	26	$97.53	$216.89	$501.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $241.05 / $537.91 / $1,135.71	Professional	TC	$241.05	$537.91	$1,135.71