Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.23 / $134.24 / $134.24	Facility	26	$96.23	$134.24	$134.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.85 / $192.00 / $399.11	Professional		$112.85	$192.00	$399.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.85 / $67.72 / $162.51	Professional	26	$52.85	$67.72	$162.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $52.62 / $89.48 / $323.37	Professional	TC	$52.62	$89.48	$323.37
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $119.82 / $286.50 / $775.62	Professional		$119.82	$286.50	$775.62
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $55.08 / $126.91 / $367.04	Professional	26	$55.08	$126.91	$367.04
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $57.73 / $164.86 / $377.96	Professional	TC	$57.73	$164.86	$377.96
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $166.71 / $194.81 / $258.92	Facility	26	$166.71	$194.81	$258.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $176.61 / $435.03 / $601.91	Professional		$176.61	$435.03	$601.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.19 / $224.79 / $255.44	Professional	26	$65.19	$224.79	$255.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $84.13 / $210.24 / $328.50	Professional	TC	$84.13	$210.24	$328.50
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $302.75 / $302.75 / $302.75	Facility	26	$302.75	$302.75	$302.75
Medica Facility/Professional Professional Modifier Low / Median / High Price $159.13 / $415.02 / $3,098.01	Professional		$159.13	$415.02	$3,098.01
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $70.76 / $165.60 / $636.41	Professional	26	$70.76	$165.60	$636.41
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $79.05 / $211.54 / $2,808.09	Professional	TC	$79.05	$211.54	$2,808.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.42 / $92.31 / $213.35	Professional		$39.42	$92.31	$213.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $244.40 / $366.15 / $828.31	Professional		$244.40	$366.15	$828.31
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $152.69 / $302.75 / $302.75	Facility	26	$152.69	$302.75	$302.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $206.87 / $1,687.24 / $3,098.01	Professional		$206.87	$1,687.24	$3,098.01
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $95.75 / $333.65 / $636.41	Professional	26	$95.75	$333.65	$636.41
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $99.98 / $1,507.97 / $2,808.09	Professional	TC	$99.98	$1,507.97	$2,808.09
Security Health Facility/Professional Professional Modifier Low / Median / High Price $294.33 / $775.17 / $775.17	Professional		$294.33	$775.17	$775.17
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $120.09 / $151.72 / $304.19	Professional	26	$120.09	$151.72	$304.19
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $148.11 / $174.25 / $566.52	Professional	TC	$148.11	$174.25	$566.52
United Facility/Professional Professional Modifier Low / Median / High Price $149.32 / $331.53 / $930.80	Professional		$149.32	$331.53	$930.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $68.13 / $143.47 / $276.52	Professional	26	$68.13	$143.47	$276.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $71.90 / $174.03 / $826.97	Professional	TC	$71.90	$174.03	$826.97