Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $171.02 / $171.02 / $191.16	Facility	26	$171.02	$171.02	$191.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $322.64 / $494.18 / $965.14	Professional		$322.64	$494.18	$965.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.57 / $140.00 / $208.06	Professional	26	$83.57	$140.00	$208.06
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $236.28 / $348.53 / $542.63	Professional	TC	$236.28	$348.53	$542.63
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $305.75 / $779.65 / $2,415.46	Professional		$305.75	$779.65	$2,415.46
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $79.65 / $189.38 / $625.13	Professional	26	$79.65	$189.38	$625.13
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $226.10 / $576.54 / $1,790.33	Professional	TC	$226.10	$576.54	$1,790.33
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $214.47 / $250.62 / $333.10	Facility	26	$214.47	$250.62	$333.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $441.22 / $1,093.71 / $1,242.84	Professional		$441.22	$1,093.71	$1,242.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $93.09 / $285.91 / $324.89	Professional	26	$93.09	$285.91	$324.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $323.41 / $807.80 / $917.95	Professional	TC	$323.41	$807.80	$917.95
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $764.32 / $764.32 / $764.32	Facility	26	$764.32	$764.32	$764.32
Medica Facility/Professional Professional Modifier Low / Median / High Price $441.69 / $1,030.18 / $3,392.38	Professional		$441.69	$1,030.18	$3,392.38
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $102.48 / $231.43 / $667.05	Professional	26	$102.48	$231.43	$667.05
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $330.67 / $826.67 / $2,981.99	Professional	TC	$330.67	$826.67	$2,981.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $80.47 / $206.50 / $555.06	Professional		$80.47	$206.50	$555.06
Quartz Facility/Professional Professional Modifier Low / Median / High Price $597.35 / $894.92 / $1,442.83	Professional		$597.35	$894.92	$1,442.83
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $194.23 / $764.32 / $764.32	Facility	26	$194.23	$764.32	$764.32
Quartz Facility/Professional Professional Modifier Low / Median / High Price $469.32 / $1,858.58 / $3,392.38	Professional		$469.32	$1,858.58	$3,392.38
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $120.42 / $427.00 / $667.05	Professional	26	$120.42	$427.00	$667.05
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $343.73 / $1,588.54 / $2,981.99	Professional	TC	$343.73	$1,588.54	$2,981.99
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,948.86 / $1,948.86 / $2,920.22	Professional		$1,948.86	$1,948.86	$2,920.22
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $364.14 / $465.72 / $621.66	Professional	26	$364.14	$465.72	$621.66
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,267.76 / $2,155.27 / $2,563.48	Professional	TC	$1,267.76	$2,155.27	$2,563.48
United Facility/Professional Professional Modifier Low / Median / High Price $407.71 / $917.35 / $1,884.73	Professional		$407.71	$917.35	$1,884.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $96.67 / $195.64 / $374.27	Professional	26	$96.67	$195.64	$374.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $305.23 / $671.92 / $1,427.75	Professional	TC	$305.23	$671.92	$1,427.75