Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.65 / $68.29 / $68.29	Facility	26	$48.65	$68.29	$68.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.88 / $93.92 / $130.90	Professional		$65.88	$93.92	$130.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.30 / $37.43 / $107.76	Professional	26	$28.30	$37.43	$107.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $37.58 / $60.52 / $85.66	Professional	TC	$37.58	$60.52	$85.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.70 / $136.66 / $466.28	Professional		$72.70	$136.66	$466.28
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.38 / $53.25 / $197.59	Professional	26	$31.38	$53.25	$197.59
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $109.05 / $214.14 / $699.42	Professional	50	$109.05	$214.14	$699.42
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $41.31 / $84.06 / $269.57	Professional	TC	$41.31	$84.06	$269.57
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.61 / $100.04 / $153.46	Facility	26	$85.61	$100.04	$153.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.66 / $265.41 / $301.60	Professional		$107.66	$265.41	$301.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.74 / $113.75 / $129.26	Professional	26	$39.74	$113.75	$129.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $60.62 / $151.62 / $172.30	Professional	TC	$60.62	$151.62	$172.30
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $145.31 / $145.31 / $145.31	Facility	26	$145.31	$145.31	$145.31
Medica Facility/Professional Professional Modifier Low / Median / High Price $101.41 / $208.00 / $583.91	Professional		$101.41	$208.00	$583.91
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $37.72 / $80.88 / $335.18	Professional	26	$37.72	$80.88	$335.18
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $64.59 / $139.26 / $353.01	Professional	TC	$64.59	$139.26	$353.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.84 / $64.69 / $188.51	Professional		$25.84	$64.69	$188.51
Quartz Facility/Professional Professional Modifier Low / Median / High Price $139.16 / $212.30 / $334.50	Professional		$139.16	$212.30	$334.50
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $145.31 / $145.31	Facility	26	$100.00	$145.31	$145.31
Quartz Facility/Professional Professional Modifier Low / Median / High Price $111.78 / $485.00 / $583.91	Professional		$111.78	$485.00	$583.91
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $47.92 / $179.60 / $335.18	Professional	26	$47.92	$179.60	$335.18
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $63.87 / $305.39 / $353.01	Professional	TC	$63.87	$305.39	$353.01
Security Health Facility/Professional Professional Modifier Low / Median / High Price $251.86 / $472.91 / $472.91	Professional		$251.86	$472.91	$472.91
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $88.31 / $103.89 / $201.61	Professional	26	$88.31	$103.89	$201.61
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $142.87 / $168.08 / $352.37	Professional	TC	$142.87	$168.08	$352.37
United Facility/Professional Professional Modifier Low / Median / High Price $91.57 / $184.04 / $373.45	Professional		$91.57	$184.04	$373.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.81 / $71.04 / $157.41	Professional	26	$36.81	$71.04	$157.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $57.46 / $119.11 / $293.33	Professional	TC	$57.46	$119.11	$293.33