Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $160.22 / $172.24 / $172.24	Facility	26	$160.22	$172.24	$172.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $228.80 / $316.23 / $895.07	Professional		$228.80	$316.23	$895.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.15 / $126.73 / $811.75	Professional	26	$77.15	$126.73	$811.75
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $144.82 / $235.18 / $317.55	Professional	TC	$144.82	$235.18	$317.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $226.69 / $578.07 / $1,777.55	Professional		$226.69	$578.07	$1,777.55
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $80.11 / $190.48 / $629.69	Professional	26	$80.11	$190.48	$629.69
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $146.58 / $385.65 / $1,147.86	Professional	TC	$146.58	$385.65	$1,147.86
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $215.37 / $251.67 / $334.50	Facility	26	$215.37	$251.67	$334.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $302.83 / $821.45 / $933.46	Professional		$302.83	$821.45	$933.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $92.38 / $287.97 / $327.24	Professional	26	$92.38	$287.97	$327.24
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $199.81 / $533.48 / $606.23	Professional	TC	$199.81	$533.48	$606.23
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $768.32 / $768.32 / $768.32	Facility	26	$768.32	$768.32	$768.32
Medica Facility/Professional Professional Modifier Low / Median / High Price $280.31 / $627.01 / $1,515.48	Professional		$280.31	$627.01	$1,515.48
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $97.69 / $222.82 / $521.79	Professional	26	$97.69	$222.82	$521.79
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $186.46 / $421.08 / $993.68	Professional	TC	$186.46	$421.08	$993.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $76.01 / $180.22 / $420.02	Professional		$76.01	$180.22	$420.02
Quartz Facility/Professional Professional Modifier Low / Median / High Price $337.46 / $547.42 / $993.28	Professional		$337.46	$547.42	$993.28
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $195.63 / $768.32 / $768.32	Facility	26	$195.63	$768.32	$768.32
Quartz Facility/Professional Professional Modifier Low / Median / High Price $345.97 / $1,205.20 / $1,515.48	Professional		$345.97	$1,205.20	$1,515.48
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $121.28 / $428.30 / $521.79	Professional	26	$121.28	$428.30	$521.79
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $224.68 / $776.90 / $993.68	Professional	TC	$224.68	$776.90	$993.68
Security Health Facility/Professional Professional Modifier Low / Median / High Price $781.10 / $1,463.67 / $1,463.67	Professional		$781.10	$1,463.67	$1,463.67
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $243.43 / $286.39 / $468.03	Professional	26	$243.43	$286.39	$468.03
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $536.35 / $632.54 / $1,272.86	Professional	TC	$536.35	$632.54	$1,272.86
United Facility/Professional Professional Modifier Low / Median / High Price $258.43 / $569.23 / $1,056.35	Professional		$258.43	$569.23	$1,056.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $94.64 / $207.87 / $375.41	Professional	26	$94.64	$207.87	$375.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $172.42 / $388.45 / $773.39	Professional	TC	$172.42	$388.45	$773.39