Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.13 / $85.11 / $125.89	Facility	26	$74.13	$85.11	$125.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $158.49 / $323.59	Professional		$109.65	$158.49	$323.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $72.44 / $131.83	Professional	26	$38.02	$72.44	$131.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $104.71 / $213.80	Professional	TC	$79.43	$104.71	$213.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $234.42 / $812.83	Professional		$151.36	$234.42	$812.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $69.18 / $223.87	Professional	26	$36.31	$69.18	$223.87
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $158.49 / $562.34	Professional	TC	$102.33	$158.49	$562.34
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $128.82 / $151.36 / $239.88	Facility	26	$128.82	$151.36	$239.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $331.13 / $630.96	Professional		$138.04	$331.13	$630.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $102.33 / $199.53	Professional	26	$38.90	$102.33	$199.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $245.47 / $426.58	Professional	TC	$104.71	$245.47	$426.58
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $331.13 / $457.09	Professional		$275.42	$331.13	$457.09
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $107.15 / $144.54	Professional	26	$87.10	$107.15	$144.54
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $223.87 / $288.40	Professional	TC	$190.55	$223.87	$288.40
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $218.78 / $218.78 / $218.78	Facility	26	$218.78	$218.78	$218.78
Medica Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $281.84 / $1,023.29	Professional		$144.54	$281.84	$1,023.29
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $87.10 / $309.03	Professional	26	$39.81	$87.10	$309.03
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $204.17 / $707.95	Professional	TC	$102.33	$204.17	$707.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $165.96	Professional		$32.36	$33.11	$165.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $363.08 / $645.65	Professional		$194.98	$363.08	$645.65
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $114.82 / $309.03 / $309.03	Facility	26	$114.82	$309.03	$309.03
Quartz Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $776.25 / $1,023.29	Professional		$177.83	$776.25	$1,023.29
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $257.04 / $309.03	Professional	26	$53.70	$257.04	$309.03
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $489.78 / $707.95	Professional	TC	$138.04	$489.78	$707.95
Security Health Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $724.44 / $954.99	Professional		$288.40	$724.44	$954.99
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $95.50 / $186.21	Professional	26	$75.86	$95.50	$186.21
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $245.47 / $501.19	Professional	TC	$151.36	$245.47	$501.19
United Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $218.78 / $489.78	Professional		$144.54	$218.78	$489.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $66.07 / $165.96	Professional	26	$39.81	$66.07	$165.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $151.36 / $354.81	Professional	TC	$102.33	$151.36	$354.81