Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.15 / $59.72 / $437.61	Facility	26	$43.15	$59.72	$437.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.68 / $113.27 / $495.00	Professional		$81.68	$113.27	$495.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.06 / $43.15 / $207.24	Professional	26	$22.06	$43.15	$207.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $60.94 / $75.80 / $193.15	Professional	TC	$60.94	$75.80	$193.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $94.10 / $212.16 / $553.15	Professional		$94.10	$212.16	$553.15
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.84 / $57.73 / $177.08	Professional	26	$27.84	$57.73	$177.08
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $63.01 / $139.38 / $404.15	Professional	TC	$63.01	$139.38	$404.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $31.73 / $80.81 / $130.26	Professional		$31.73	$80.81	$130.26
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.79 / $87.40 / $116.16	Facility	26	$74.79	$87.40	$116.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $96.10 / $342.44 / $389.14	Professional		$96.10	$342.44	$389.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.40 / $99.33 / $112.88	Professional	26	$26.40	$99.33	$112.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $66.19 / $243.08 / $276.23	Professional	TC	$66.19	$243.08	$276.23
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $128.65 / $128.65 / $249.00	Facility	26	$128.65	$128.65	$249.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $99.02 / $224.15 / $648.50	Professional		$99.02	$224.15	$648.50
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $30.68 / $71.19 / $180.32	Professional	26	$30.68	$71.19	$180.32
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $69.37 / $158.68 / $468.12	Professional	TC	$69.37	$158.68	$468.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.00 / $79.45 / $186.96	Professional		$38.00	$79.45	$186.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $187.20 / $227.17 / $379.77	Professional		$187.20	$227.17	$379.77
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $128.65 / $128.65	Facility	26	$100.00	$128.65	$128.65
Quartz Facility/Professional Professional Modifier Low / Median / High Price $144.22 / $465.05 / $648.50	Professional		$144.22	$465.05	$648.50
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $41.84 / $147.69 / $180.32	Professional	26	$41.84	$147.69	$180.32
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $107.02 / $317.39 / $468.12	Professional	TC	$107.02	$317.39	$468.12
Security Health Facility/Professional Professional Modifier Low / Median / High Price $189.92 / $578.48 / $610.17	Professional		$189.92	$578.48	$610.17
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $50.75 / $74.26 / $135.76	Professional	26	$50.75	$74.26	$135.76
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $103.17 / $139.16 / $393.70	Professional	TC	$103.17	$139.16	$393.70
United Facility/Professional Professional Modifier Low / Median / High Price $98.27 / $199.97 / $385.43	Professional		$98.27	$199.97	$385.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.38 / $61.36 / $119.30	Professional	26	$29.38	$61.36	$119.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $67.12 / $136.46 / $278.16	Professional	TC	$67.12	$136.46	$278.16