Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.85 / $37.97 / $52.54	Facility	26	$26.85	$37.97	$52.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.14 / $134.30 / $427.36	Professional		$92.14	$134.30	$427.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.35 / $38.21 / $203.70	Professional	26	$23.35	$38.21	$203.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.84 / $108.59 / $189.37	Professional	TC	$67.84	$108.59	$189.37
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $122.80 / $259.50 / $803.15	Professional		$122.80	$259.50	$803.15
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.50 / $56.59 / $157.65	Professional	26	$24.50	$56.59	$157.65
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $97.39 / $200.94 / $631.16	Professional	TC	$97.39	$200.94	$631.16
CareSource Facility/Professional Professional Modifier Low / Median / High Price $27.94 / $109.63 / $164.45	Professional		$27.94	$109.63	$164.45
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.78 / $76.87 / $102.17	Facility	26	$65.78	$76.87	$102.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $110.71 / $438.20 / $497.95	Professional		$110.71	$438.20	$497.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.73 / $88.43 / $100.49	Professional	26	$29.73	$88.43	$100.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $89.45 / $349.77 / $397.46	Professional	TC	$89.45	$349.77	$397.46
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $113.54 / $113.54 / $113.54	Facility	26	$113.54	$113.54	$113.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $124.80 / $293.44 / $841.81	Professional		$124.80	$293.44	$841.81
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $29.76 / $69.19 / $205.77	Professional	26	$29.76	$69.19	$205.77
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $94.43 / $227.48 / $680.78	Professional	TC	$94.43	$227.48	$680.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.31 / $103.95 / $249.95	Professional		$55.31	$103.95	$249.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $226.07 / $289.08 / $529.86	Professional		$226.07	$289.08	$529.86
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $113.54 / $113.54	Facility	26	$100.00	$113.54	$113.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $184.55 / $624.79 / $841.81	Professional		$184.55	$624.79	$841.81
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $40.96 / $131.05 / $205.77	Professional	26	$40.96	$131.05	$205.77
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $147.31 / $493.75 / $680.78	Professional	TC	$147.31	$493.75	$680.78
Security Health Facility/Professional Professional Modifier Low / Median / High Price $224.91 / $763.12 / $780.77	Professional		$224.91	$763.12	$780.77
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $58.63 / $74.18 / $142.61	Professional	26	$58.63	$74.18	$142.61
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $118.35 / $216.95 / $490.72	Professional	TC	$118.35	$216.95	$490.72
United Facility/Professional Professional Modifier Low / Median / High Price $124.80 / $237.42 / $547.64	Professional		$124.80	$237.42	$547.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.58 / $60.91 / $114.87	Professional	26	$28.58	$60.91	$114.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $94.43 / $156.94 / $409.22	Professional	TC	$94.43	$156.94	$409.22