Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.63 / $26.02 / $31.43	Facility	26	$22.63	$26.02	$31.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.03 / $61.71 / $118.34	Professional		$36.03	$61.71	$118.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.58 / $22.63 / $90.27	Professional	26	$13.58	$22.63	$90.27
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.51 / $39.09 / $88.78	Professional	TC	$22.51	$39.09	$88.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $84.79 / $246.28	Professional		$39.81	$84.79	$246.28
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.60 / $33.49 / $93.30	Professional	26	$14.60	$33.49	$93.30
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.70 / $58.08 / $151.34	Professional	TC	$23.70	$58.08	$151.34
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.65 / $46.33 / $61.58	Facility	26	$39.65	$46.33	$61.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.92 / $144.74 / $164.48	Professional		$56.92	$144.74	$164.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.84 / $52.92 / $60.14	Professional	26	$17.84	$52.92	$60.14
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.34 / $91.86 / $104.39	Professional	TC	$35.34	$91.86	$104.39
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $46.61 / $105.26 / $390.88	Professional		$46.61	$105.26	$390.88
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $17.94 / $41.02 / $103.00	Professional	26	$17.94	$41.02	$103.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $26.97 / $70.64 / $301.75	Professional	TC	$26.97	$70.64	$301.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.71 / $46.32 / $77.04	Professional		$19.71	$46.32	$77.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $80.59 / $120.75 / $177.32	Professional		$80.59	$120.75	$177.32
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $67.06 / $243.29 / $390.88	Professional		$67.06	$243.29	$390.88
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $24.51 / $78.84 / $103.00	Professional	26	$24.51	$78.84	$103.00
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $42.55 / $190.33 / $301.75	Professional	TC	$42.55	$190.33	$301.75
Security Health Facility/Professional Professional Modifier Low / Median / High Price $81.53 / $233.52 / $257.92	Professional		$81.53	$233.52	$257.92
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $35.40 / $44.80 / $84.36	Professional	26	$35.40	$44.80	$84.36
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $39.20 / $46.12 / $145.72	Professional	TC	$39.20	$46.12	$145.72
United Facility/Professional Professional Modifier Low / Median / High Price $43.37 / $91.21 / $170.43	Professional		$43.37	$91.21	$170.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.80 / $35.26 / $69.12	Professional	26	$16.80	$35.26	$69.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.39 / $60.33 / $115.37	Professional	TC	$25.39	$60.33	$115.37