Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.65 / $66.29 / $80.08	Facility	26	$57.65	$66.29	$80.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.04 / $143.57 / $615.00	Professional		$101.04	$143.57	$615.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.76 / $58.40 / $329.48	Professional	26	$31.76	$58.40	$329.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $71.14 / $92.23 / $172.28	Professional	TC	$71.14	$92.23	$172.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $118.96 / $246.69 / $711.77	Professional		$118.96	$246.69	$711.77
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.38 / $77.76 / $225.25	Professional	26	$36.38	$77.76	$225.25
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $83.49 / $170.66 / $486.51	Professional	TC	$83.49	$170.66	$486.51
CareSource Facility/Professional Professional Modifier Low / Median / High Price $42.54 / $98.71 / $163.91	Professional		$42.54	$98.71	$163.91
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.02 / $116.89 / $155.35	Facility	26	$100.02	$116.89	$155.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $118.88 / $431.79 / $490.68	Professional		$118.88	$431.79	$490.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.18 / $133.63 / $151.85	Professional	26	$39.18	$133.63	$151.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $79.67 / $298.17 / $338.83	Professional	TC	$79.67	$298.17	$338.83
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $172.60 / $172.60 / $172.60	Facility	26	$172.60	$172.60	$172.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $123.86 / $280.08 / $812.81	Professional		$123.86	$280.08	$812.81
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $42.53 / $99.33 / $240.49	Professional	26	$42.53	$99.33	$240.49
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $80.84 / $191.22 / $572.32	Professional	TC	$80.84	$191.22	$572.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.20 / $102.63 / $247.12	Professional		$38.20	$102.63	$247.12
Quartz Facility/Professional Professional Modifier Low / Median / High Price $235.30 / $285.55 / $485.42	Professional		$235.30	$285.55	$485.42
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $172.60 / $172.60	Facility	26	$100.00	$172.60	$172.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $181.87 / $581.10 / $812.81	Professional		$181.87	$581.10	$812.81
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $58.06 / $198.65 / $240.49	Professional	26	$58.06	$198.65	$240.49
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $127.99 / $382.45 / $572.32	Professional	TC	$127.99	$382.45	$572.32
Security Health Facility/Professional Professional Modifier Low / Median / High Price $242.95 / $719.51 / $769.44	Professional		$242.95	$719.51	$769.44
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $76.33 / $99.61 / $188.16	Professional	26	$76.33	$99.61	$188.16
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $127.45 / $166.62 / $459.44	Professional	TC	$127.45	$166.62	$459.44
United Facility/Professional Professional Modifier Low / Median / High Price $122.34 / $240.73 / $500.52	Professional		$122.34	$240.73	$500.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.50 / $86.22 / $174.12	Professional	26	$41.50	$86.22	$174.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $80.84 / $145.33 / $335.21	Professional	TC	$80.84	$145.33	$335.21