Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.66 / $94.12 / $94.12	Facility	26	$87.66	$94.12	$94.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $130.07 / $174.28 / $277.54	Professional		$130.07	$174.28	$277.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.78 / $58.46 / $101.55	Professional	26	$43.78	$58.46	$101.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $84.10 / $119.70 / $165.99	Professional	TC	$84.10	$119.70	$165.99
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.50 / $310.56 / $1,036.32	Professional		$131.50	$310.56	$1,036.32
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $43.83 / $104.21 / $346.20	Professional	26	$43.83	$104.21	$346.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $87.67 / $208.79 / $690.13	Professional	TC	$87.67	$208.79	$690.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.05 / $137.94 / $183.34	Facility	26	$118.05	$137.94	$183.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $186.45 / $471.10 / $535.34	Professional		$186.45	$471.10	$535.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.96 / $157.66 / $179.16	Professional	26	$52.96	$157.66	$179.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $122.31 / $313.43 / $356.18	Professional	TC	$122.31	$313.43	$356.18
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $422.56 / $422.56 / $422.56	Facility	26	$422.56	$422.56	$422.56
Medica Facility/Professional Professional Modifier Low / Median / High Price $167.81 / $372.14 / $1,035.22	Professional		$167.81	$372.14	$1,035.22
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $54.35 / $125.71 / $287.12	Professional	26	$54.35	$125.71	$287.12
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $110.70 / $254.52 / $780.77	Professional	TC	$110.70	$254.52	$780.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $56.22 / $105.44 / $250.42	Professional		$56.22	$105.44	$250.42
Quartz Facility/Professional Professional Modifier Low / Median / High Price $258.70 / $387.57 / $582.65	Professional		$258.70	$387.57	$582.65
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $107.10 / $422.56 / $422.56	Facility	26	$107.10	$422.56	$422.56
Quartz Facility/Professional Professional Modifier Low / Median / High Price $198.41 / $615.29 / $1,035.22	Professional		$198.41	$615.29	$1,035.22
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $66.40 / $237.95 / $287.12	Professional	26	$66.40	$237.95	$287.12
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $132.01 / $418.69 / $780.77	Professional	TC	$132.01	$418.69	$780.77
Security Health Facility/Professional Professional Modifier Low / Median / High Price $472.28 / $831.03 / $831.03	Professional		$472.28	$831.03	$831.03
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $145.66 / $161.72 / $263.69	Professional	26	$145.66	$161.72	$263.69
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $310.55 / $348.97 / $666.08	Professional	TC	$310.55	$348.97	$666.08
United Facility/Professional Professional Modifier Low / Median / High Price $160.58 / $340.02 / $696.04	Professional		$160.58	$340.02	$696.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.99 / $114.69 / $208.56	Professional	26	$51.99	$114.69	$208.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $98.80 / $227.49 / $514.30	Professional	TC	$98.80	$227.49	$514.30