Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.90 / $69.31 / $69.31	Facility	26	$49.90	$69.31	$69.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $99.28 / $127.34 / $359.75	Professional		$99.28	$127.34	$359.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.88 / $49.90 / $195.21	Professional	26	$29.88	$49.90	$195.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.81 / $87.37 / $156.26	Professional	TC	$67.81	$87.37	$156.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $105.21 / $234.53 / $679.38	Professional		$105.21	$234.53	$679.38
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.19 / $74.38 / $207.19	Professional	26	$32.19	$74.38	$207.19
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $72.09 / $157.59 / $456.49	Professional	TC	$72.09	$157.59	$456.49
CareSource Facility/Professional Professional Modifier Low / Median / High Price $36.88 / $89.56 / $146.54	Professional		$36.88	$89.56	$146.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.51 / $101.09 / $134.36	Facility	26	$86.51	$101.09	$134.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $122.31 / $385.57 / $438.15	Professional		$122.31	$385.57	$438.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.01 / $115.52 / $131.28	Professional	26	$39.01	$115.52	$131.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $83.41 / $270.05 / $306.88	Professional	TC	$83.41	$270.05	$306.88
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $149.85 / $149.85 / $149.85	Facility	26	$149.85	$149.85	$149.85
Medica Facility/Professional Professional Modifier Low / Median / High Price $115.98 / $260.69 / $730.62	Professional		$115.98	$260.69	$730.62
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $38.96 / $89.80 / $210.44	Professional	26	$38.96	$89.80	$210.44
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $77.73 / $176.68 / $520.19	Professional	TC	$77.73	$176.68	$520.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $37.48 / $77.58 / $186.96	Professional		$37.48	$77.58	$186.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $196.30 / $255.57 / $367.93	Professional		$196.30	$255.57	$367.93
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $78.48 / $149.85 / $149.85	Facility	26	$78.48	$149.85	$149.85
Quartz Facility/Professional Professional Modifier Low / Median / High Price $162.38 / $525.95 / $730.62	Professional		$162.38	$525.95	$730.62
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $51.54 / $172.60 / $210.44	Professional	26	$51.54	$172.60	$210.44
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $113.74 / $353.35 / $520.19	Professional	TC	$113.74	$353.35	$520.19
Security Health Facility/Professional Professional Modifier Low / Median / High Price $209.91 / $650.01 / $687.04	Professional		$209.91	$650.01	$687.04
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $64.73 / $76.15 / $157.04	Professional	26	$64.73	$76.15	$157.04
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $133.52 / $157.09 / $362.71	Professional	TC	$133.52	$157.09	$362.71
United Facility/Professional Professional Modifier Low / Median / High Price $86.60 / $112.00 / $550.21	Professional		$86.60	$112.00	$550.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.72 / $80.39 / $151.29	Professional	26	$35.72	$80.39	$151.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $77.73 / $175.54 / $309.70	Professional	TC	$77.73	$175.54	$309.70