Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $133.72 / $186.75 / $186.75	Facility	26	$133.72	$186.75	$186.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.47 / $240.33 / $474.42	Professional		$144.47	$240.33	$474.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.42 / $90.24 / $186.75	Professional	26	$60.42	$90.24	$186.75
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $62.15 / $106.61 / $306.81	Professional	TC	$62.15	$106.61	$306.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $155.05 / $366.35 / $997.90	Professional		$155.05	$366.35	$997.90
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $86.27 / $176.35 / $510.47	Professional	26	$86.27	$176.35	$510.47
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $68.78 / $195.36 / $445.33	Professional	TC	$68.78	$195.36	$445.33
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $232.49 / $271.68 / $361.09	Facility	26	$232.49	$271.68	$361.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $230.57 / $564.87 / $641.90	Professional		$230.57	$564.87	$641.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.20 / $313.14 / $355.85	Professional	26	$77.20	$313.14	$355.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $102.05 / $251.69 / $393.24	Professional	TC	$102.05	$251.69	$393.24
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $413.29 / $413.29 / $413.29	Facility	26	$413.29	$413.29	$413.29
Medica Facility/Professional Professional Modifier Low / Median / High Price $201.67 / $539.34 / $3,140.08	Professional		$201.67	$539.34	$3,140.08
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $92.91 / $216.38 / $681.88	Professional	26	$92.91	$216.38	$681.88
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $91.10 / $258.88 / $2,808.09	Professional	TC	$91.10	$258.88	$2,808.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.40 / $133.90 / $321.50	Professional		$58.40	$133.90	$321.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $316.55 / $474.24 / $1,220.58	Professional		$316.55	$474.24	$1,220.58
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $212.73 / $413.29 / $413.29	Facility	26	$212.73	$413.29	$413.29
Quartz Facility/Professional Professional Modifier Low / Median / High Price $268.60 / $1,713.35 / $3,140.08	Professional		$268.60	$1,713.35	$3,140.08
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $131.88 / $460.70 / $681.88	Professional	26	$131.88	$460.70	$681.88
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $119.69 / $1,507.97 / $2,808.09	Professional	TC	$119.69	$1,507.97	$2,808.09
Security Health Facility/Professional Professional Modifier Low / Median / High Price $400.14 / $1,006.49 / $1,006.49	Professional		$400.14	$1,006.49	$1,006.49
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $121.38 / $138.22 / $422.70	Professional	26	$121.38	$138.22	$422.70
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $209.53 / $261.91 / $857.97	Professional	TC	$209.53	$261.91	$857.97
United Facility/Professional Professional Modifier Low / Median / High Price $189.35 / $420.88 / $978.31	Professional		$189.35	$420.88	$978.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $96.17 / $189.48 / $403.80	Professional	26	$96.17	$189.48	$403.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $80.48 / $193.52 / $614.89	Professional	TC	$80.48	$193.52	$614.89