Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.41 / $53.68 / $57.56	Facility	26	$29.41	$53.68	$57.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.51 / $126.65 / $510.00	Professional		$66.51	$126.65	$510.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.41 / $41.89 / $148.97	Professional	26	$26.41	$41.89	$148.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $48.13 / $90.77 / $155.32	Professional	TC	$48.13	$90.77	$155.32
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $99.38 / $228.63 / $762.21	Professional		$99.38	$228.63	$762.21
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.84 / $63.82 / $208.38	Professional	26	$26.84	$63.82	$208.38
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $72.20 / $166.63 / $547.79	Professional	TC	$72.20	$166.63	$547.79
CareSource Facility/Professional Professional Modifier Low / Median / High Price $30.59 / $89.22 / $138.03	Professional		$30.59	$89.22	$138.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.09 / $84.24 / $111.97	Facility	26	$72.09	$84.24	$111.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.41 / $359.15 / $408.13	Professional		$104.41	$359.15	$408.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.49 / $95.72 / $108.78	Professional	26	$30.49	$95.72	$108.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $73.69 / $263.43 / $299.35	Professional	TC	$73.69	$263.43	$299.35
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $255.84 / $255.84 / $255.84	Facility	26	$255.84	$255.84	$255.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $107.59 / $249.65 / $659.39	Professional		$107.59	$249.65	$659.39
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $32.14 / $75.20 / $173.89	Professional	26	$32.14	$75.20	$173.89
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $77.89 / $181.61 / $485.50	Professional	TC	$77.89	$181.61	$485.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.00 / $80.11 / $186.96	Professional		$38.00	$80.11	$186.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $117.05 / $241.37 / $434.28	Professional		$117.05	$241.37	$434.28
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $65.03 / $255.84 / $255.84	Facility	26	$65.03	$255.84	$255.84
Quartz Facility/Professional Professional Modifier Low / Median / High Price $151.26 / $625.00 / $659.39	Professional		$151.26	$625.00	$659.39
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $40.31 / $173.89 / $175.00	Professional	26	$40.31	$173.89	$175.00
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $110.95 / $450.00 / $485.50	Professional	TC	$110.95	$450.00	$485.50
Security Health Facility/Professional Professional Modifier Low / Median / High Price $310.36 / $639.91 / $639.91	Professional		$310.36	$639.91	$639.91
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $80.81 / $95.07 / $154.01	Professional	26	$80.81	$95.07	$154.01
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $196.88 / $231.62 / $480.10	Professional	TC	$196.88	$231.62	$480.10
United Facility/Professional Professional Modifier Low / Median / High Price $112.48 / $187.22 / $443.51	Professional		$112.48	$187.22	$443.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.40 / $66.58 / $133.28	Professional	26	$30.40	$66.58	$133.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $76.87 / $147.47 / $318.74	Professional	TC	$76.87	$147.47	$318.74