Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.90 / $57.38 / $69.31	Facility	26	$49.90	$57.38	$69.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.23 / $91.78 / $226.47	Professional		$73.23	$91.78	$226.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.88 / $49.90 / $197.83	Professional	26	$29.88	$49.90	$197.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $43.44 / $53.82 / $100.53	Professional	TC	$43.44	$53.82	$100.53
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $80.08 / $178.52 / $517.12	Professional		$80.08	$178.52	$517.12
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 $46.48 / $101.57 / $294.23	Professional	TC	$46.48	$101.57	$294.23
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 $92.32 / $289.41 / $328.88	Professional		$92.32	$289.41	$328.88
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 $53.43 / $173.92 / $197.64	Professional	TC	$53.43	$173.92	$197.64
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 $87.93 / $200.18 / $546.16	Professional		$87.93	$200.18	$546.16
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $38.96 / $89.75 / $210.44	Professional	26	$38.96	$89.75	$210.44
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $50.07 / $114.42 / $335.78	Professional	TC	$50.07	$114.42	$335.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.28 / $61.91 / $186.31	Professional		$21.28	$61.91	$186.31
Quartz Facility/Professional Professional Modifier Low / Median / High Price $148.85 / $192.47 / $277.08	Professional		$148.85	$192.47	$277.08
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 $121.90 / $400.35 / $546.16	Professional		$121.90	$400.35	$546.16
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 $73.25 / $227.75 / $335.78	Professional	TC	$73.25	$227.75	$335.78
Security Health Facility/Professional Professional Modifier Low / Median / High Price $159.66 / $489.26 / $515.71	Professional		$159.66	$489.26	$515.71
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 $86.06 / $101.25 / $234.18	Professional	TC	$86.06	$101.25	$234.18
United Facility/Professional Professional Modifier Low / Median / High Price $86.35 / $172.15 / $350.91	Professional		$86.35	$172.15	$350.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.17 / $78.94 / $145.79	Professional	26	$38.17	$78.94	$145.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $48.00 / $104.93 / $199.62	Professional	TC	$48.00	$104.93	$199.62