Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.10 / $57.56 / $57.56	Facility	26	$42.10	$57.56	$57.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.34 / $106.74 / $181.62	Professional		$78.34	$106.74	$181.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $53.19 / $78.43 / $113.87	Professional	TC	$53.19	$78.43	$113.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.83 / $199.97 / $554.50	Professional		$86.83	$199.97	$554.50
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $59.66 / $129.53 / $375.23	Professional	TC	$59.66	$129.53	$375.23
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.98 / $85.30 / $113.36	Facility	26	$72.98	$85.30	$113.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $96.51 / $314.17 / $357.01	Professional		$96.51	$314.17	$357.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $62.77 / $217.27 / $246.90	Professional	TC	$62.77	$217.27	$246.90
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $124.11 / $124.11 / $124.11	Facility	26	$124.11	$124.11	$124.11
Medica Facility/Professional Professional Modifier Low / Median / High Price $107.03 / $241.94 / $673.71	Professional		$107.03	$241.94	$673.71
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $72.73 / $168.56 / $514.25	Professional	TC	$72.73	$168.56	$514.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.20 / $80.11 / $186.96	Professional		$38.20	$80.11	$186.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $171.60 / $209.09 / $379.90	Professional		$171.60	$209.09	$379.90
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $124.11 / $124.11	Facility	26	$100.00	$124.11	$124.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $145.56 / $469.45 / $673.71	Professional		$145.56	$469.45	$673.71
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $99.44 / $319.10 / $514.25	Professional	TC	$99.44	$319.10	$514.25
Security Health Facility/Professional Professional Modifier Low / Median / High Price $197.17 / $559.84 / $559.84	Professional		$197.17	$559.84	$559.84
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $109.24 / $128.49 / $401.22	Professional	TC	$109.24	$128.49	$401.22
United Facility/Professional Professional Modifier Low / Median / High Price $104.56 / $214.38 / $411.47	Professional		$104.56	$214.38	$411.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $67.48 / $149.84 / $264.43	Professional	TC	$67.48	$149.84	$264.43