Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.62 / $77.62 / $109.65	Facility	26	$77.62	$77.62	$109.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $223.87 / $512.86	Professional		$173.78	$223.87	$512.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $54.95 / $169.82	Professional	26	$42.66	$54.95	$169.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $165.96 / $288.40	Professional	TC	$131.83	$165.96	$288.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $331.13 / $1,148.15	Professional		$204.17	$331.13	$1,148.15
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $81.28 / $281.84	Professional	26	$51.29	$81.28	$281.84
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $257.04 / $851.14	Professional	TC	$154.88	$257.04	$851.14
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $138.04 / $158.49 / $257.04	Facility	26	$138.04	$158.49	$257.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $478.63 / $851.14	Professional		$208.93	$478.63	$851.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $109.65 / $213.80	Professional	26	$47.86	$109.65	$213.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $363.08 / $630.96	Professional	TC	$158.49	$363.08	$630.96
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $446.68 / $602.56	Professional		$371.54	$446.68	$602.56
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $114.82 / $154.88	Professional	26	$95.50	$114.82	$154.88
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $331.13 / $457.09	Professional	TC	$275.42	$331.13	$457.09
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $234.42 / $234.42 / $234.42	Facility	26	$234.42	$234.42	$234.42
Medica Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $436.52 / $1,380.38	Professional		$234.42	$436.52	$1,380.38
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $109.65 / $331.13	Professional	26	$57.54	$109.65	$331.13
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $338.84 / $1,047.13	Professional	TC	$177.83	$338.84	$1,047.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $70.79	Professional		$32.36	$33.11	$70.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $467.74 / $676.08	Professional		$257.04	$467.74	$676.08
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $120.23 / $331.13 / $331.13	Facility	26	$120.23	$331.13	$331.13
Quartz Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $1,122.02 / $1,380.38	Professional		$281.84	$1,122.02	$1,380.38
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $275.42 / $331.13	Professional	26	$66.07	$275.42	$331.13
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $851.14 / $1,047.13	Professional	TC	$213.80	$851.14	$1,047.13
Security Health Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $1,047.13 / $1,479.11	Professional		$457.09	$1,047.13	$1,479.11
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $123.03 / $245.47	Professional	26	$104.71	$123.03	$245.47
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $331.13 / $389.05 / $794.33	Professional	TC	$331.13	$389.05	$794.33
United Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $371.54 / $831.76	Professional		$234.42	$371.54	$831.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $93.33 / $204.17	Professional	26	$57.54	$93.33	$204.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $281.84 / $630.96	Professional	TC	$177.83	$281.84	$630.96