Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.06 / $78.66 / $140.19	Facility	26	$73.06	$78.66	$140.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.00 / $135.87 / $449.30	Professional		$79.00	$135.87	$449.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.09 / $52.67 / $240.10	Professional	26	$36.09	$52.67	$240.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $40.57 / $64.37 / $119.70	Professional	TC	$40.57	$64.37	$119.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.48 / $149.91 / $423.42	Professional		$71.48	$149.91	$423.42
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.53 / $84.40 / $235.12	Professional	26	$36.53	$84.40	$235.12
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $31.21 / $70.48 / $211.20	Professional	TC	$31.21	$70.48	$211.20
CareSource Facility/Professional Professional Modifier Low / Median / High Price $40.04 / $50.23 / $121.91	Professional		$40.04	$50.23	$121.91
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $99.12 / $115.83 / $153.94	Facility	26	$99.12	$115.83	$153.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $108.37 / $273.14 / $310.39	Professional		$108.37	$273.14	$310.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.01 / $131.63 / $149.59	Professional	26	$46.01	$131.63	$149.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $56.88 / $141.50 / $160.80	Professional	TC	$56.88	$141.50	$160.80
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $169.56 / $169.56 / $169.56	Facility	26	$169.56	$169.56	$169.56
Medica Facility/Professional Professional Modifier Low / Median / High Price $83.54 / $192.09 / $1,002.61	Professional		$83.54	$192.09	$1,002.61
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $44.59 / $103.11 / $238.39	Professional	26	$44.59	$103.11	$238.39
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $36.72 / $95.77 / $780.59	Professional	TC	$36.72	$95.77	$780.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.04 / $61.91 / $182.82	Professional		$25.04	$61.91	$182.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $154.69 / $231.76 / $316.72	Professional		$154.69	$231.76	$316.72
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $89.43 / $169.56 / $169.56	Facility	26	$89.43	$169.56	$169.56
Quartz Facility/Professional Professional Modifier Low / Median / High Price $126.54 / $553.72 / $1,002.61	Professional		$126.54	$553.72	$1,002.61
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $58.64 / $195.10 / $238.39	Professional	26	$58.64	$195.10	$238.39
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $64.78 / $424.36 / $780.59	Professional	TC	$64.78	$424.36	$780.59
Security Health Facility/Professional Professional Modifier Low / Median / High Price $154.44 / $486.65 / $486.65	Professional		$154.44	$486.65	$486.65
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $87.72 / $110.99 / $222.83	Professional	26	$87.72	$110.99	$222.83
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $56.70 / $66.70 / $245.28	Professional	TC	$56.70	$66.70	$245.28
United Facility/Professional Professional Modifier Low / Median / High Price $78.26 / $174.05 / $393.09	Professional		$78.26	$174.05	$393.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.65 / $94.88 / $171.01	Professional	26	$42.65	$94.88	$171.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $33.67 / $79.59 / $210.15	Professional	TC	$33.67	$79.59	$210.15