Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.13 / $47.29 / $56.90	Facility	26	$41.13	$47.29	$56.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.77 / $88.15 / $456.88	Professional		$53.77	$88.15	$456.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.03 / $41.13 / $218.50	Professional	26	$24.03	$41.13	$218.50
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $24.85 / $42.36 / $310.25	Professional	52	$24.85	$42.36	$310.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.59 / $55.88 / $119.35	Professional	TC	$26.59	$55.88	$119.35
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.65 / $121.15 / $363.13	Professional		$54.65	$121.15	$363.13
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.54 / $41.13 / $156.71	Professional	26	$26.54	$41.13	$156.71
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.11 / $75.23 / $199.85	Professional	TC	$28.11	$75.23	$199.85
CareSource Facility/Professional Professional Modifier Low / Median / High Price $27.59 / $37.04 / $72.97	Professional		$27.59	$37.04	$72.97
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.29 / $82.14 / $126.00	Facility	26	$70.29	$82.14	$126.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.50 / $200.50 / $227.84	Professional		$83.50	$200.50	$227.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.24 / $94.58 / $107.48	Professional	26	$31.24	$94.58	$107.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $47.71 / $105.92 / $120.36	Professional	TC	$47.71	$105.92	$120.36
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $122.62 / $122.62 / $252.00	Facility	26	$122.62	$122.62	$252.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $87.48 / $172.54 / $447.95	Professional		$87.48	$172.54	$447.95
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $29.59 / $64.95 / $265.83	Professional	26	$29.59	$64.95	$265.83
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $55.18 / $109.76 / $398.99	Professional	TC	$55.18	$109.76	$398.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.84 / $60.81 / $127.76	Professional		$25.84	$60.81	$127.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $108.59 / $165.65 / $293.62	Professional		$108.59	$165.65	$293.62
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $122.62 / $122.62	Facility	26	$100.00	$122.62	$122.62
Quartz Facility/Professional Professional Modifier Low / Median / High Price $84.45 / $382.80 / $447.95	Professional		$84.45	$382.80	$447.95
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $39.84 / $142.44 / $265.83	Professional	26	$39.84	$142.44	$265.83
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $44.61 / $240.30 / $398.99	Professional	TC	$44.61	$240.30	$398.99
Security Health Facility/Professional Professional Modifier Low / Median / High Price $212.42 / $357.32 / $357.32	Professional		$212.42	$357.32	$357.32
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $78.25 / $91.04 / $148.41	Professional	26	$78.25	$91.04	$148.41
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $121.38 / $174.11 / $348.61	Professional	TC	$121.38	$174.11	$348.61
United Facility/Professional Professional Modifier Low / Median / High Price $80.48 / $154.54 / $335.52	Professional		$80.48	$154.54	$335.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.46 / $56.22 / $124.86	Professional	26	$29.46	$56.22	$124.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $50.58 / $95.15 / $210.66	Professional	TC	$50.58	$95.15	$210.66