Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.90 / $88.76 / $88.76	Facility	26	$63.90	$88.76	$88.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.72 / $171.97 / $629.73	Professional		$115.72	$171.97	$629.73
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.21 / $63.90 / $340.00	Professional	26	$33.21	$63.90	$340.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.23 / $109.14 / $200.79	Professional	TC	$79.23	$109.14	$200.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $132.41 / $280.93 / $799.89	Professional		$132.41	$280.93	$799.89
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.70 / $84.28 / $244.02	Professional	26	$36.70	$84.28	$244.02
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $95.72 / $197.90 / $573.29	Professional	TC	$95.72	$197.90	$573.29
CareSource Facility/Professional Professional Modifier Low / Median / High Price $47.14 / $112.63 / $185.31	Professional		$47.14	$112.63	$185.31
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $111.74 / $130.58 / $173.55	Facility	26	$111.74	$130.58	$173.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $135.36 / $489.02 / $555.70	Professional		$135.36	$489.02	$555.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.18 / $148.63 / $168.91	Professional	26	$39.18	$148.63	$168.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $92.84 / $340.37 / $386.79	Professional	TC	$92.84	$340.37	$386.79
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $190.76 / $190.76 / $190.76	Facility	26	$190.76	$190.76	$190.76
Medica Facility/Professional Professional Modifier Low / Median / High Price $141.65 / $322.63 / $927.52	Professional		$141.65	$322.63	$927.52
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $46.16 / $104.86 / $268.38	Professional	26	$46.16	$104.86	$268.38
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $94.56 / $223.51 / $659.08	Professional	TC	$94.56	$223.51	$659.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.31 / $105.44 / $250.42	Professional		$55.31	$105.44	$250.42
Quartz Facility/Professional Professional Modifier Low / Median / High Price $265.85 / $324.83 / $543.23	Professional		$265.85	$324.83	$543.23
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.98 / $190.76 / $190.76	Facility	26	$100.98	$190.76	$190.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $214.90 / $669.35 / $927.52	Professional		$214.90	$669.35	$927.52
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $62.60 / $221.80 / $268.38	Professional	26	$62.60	$221.80	$268.38
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $151.30 / $447.55 / $659.08	Professional	TC	$151.30	$447.55	$659.08
Security Health Facility/Professional Professional Modifier Low / Median / High Price $246.11 / $826.14 / $871.37	Professional		$246.11	$826.14	$871.37
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $76.33 / $111.38 / $201.12	Professional	26	$76.33	$111.38	$201.12
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $145.66 / $197.12 / $543.99	Professional	TC	$145.66	$197.12	$543.99
United Facility/Professional Professional Modifier Low / Median / High Price $140.75 / $280.22 / $586.69	Professional		$140.75	$280.22	$586.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.05 / $86.21 / $185.28	Professional	26	$44.05	$86.21	$185.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $94.56 / $180.50 / $392.28	Professional	TC	$94.56	$180.50	$392.28