Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.03 / $53.98 / $54.64	Facility	26	$39.03	$53.98	$54.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.06 / $159.94 / $484.50	Professional		$86.06	$159.94	$484.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.64 / $39.18 / $102.82	Professional	26	$24.64	$39.18	$102.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.40 / $89.04 / $360.45	Professional	TC	$61.40	$89.04	$360.45
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $103.19 / $163.30 / $593.62	Professional		$103.19	$163.30	$593.62
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.18 / $41.73 / $148.77	Professional	26	$25.18	$41.73	$148.77
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $78.01 / $123.19 / $440.46	Professional	TC	$78.01	$123.19	$440.46
CareSource Facility/Professional Professional Modifier Low / Median / High Price $27.52 / $89.64 / $131.13	Professional		$27.52	$89.64	$131.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.58 / $78.98 / $121.15	Facility	26	$67.58	$78.98	$121.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $113.21 / $374.97 / $426.10	Professional		$113.21	$374.97	$426.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.78 / $90.86 / $103.25	Professional	26	$32.78	$90.86	$103.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $81.90 / $284.11 / $322.85	Professional	TC	$81.90	$284.11	$322.85
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $116.58 / $116.58 / $516.00	Facility	26	$116.58	$116.58	$516.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $115.85 / $211.77 / $692.04	Professional		$115.85	$211.77	$692.04
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $29.56 / $54.88 / $165.29	Professional	26	$29.56	$54.88	$165.29
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $87.16 / $156.33 / $526.74	Professional	TC	$87.16	$156.33	$526.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.42 / $107.91 / $253.57	Professional		$39.42	$107.91	$253.57
Quartz Facility/Professional Professional Modifier Low / Median / High Price $182.08 / $252.42 / $408.35	Professional		$182.08	$252.42	$408.35
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $61.73 / $116.58 / $116.58	Facility	26	$61.73	$116.58	$116.58
Quartz Facility/Professional Professional Modifier Low / Median / High Price $157.93 / $458.51 / $692.04	Professional		$157.93	$458.51	$692.04
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $38.27 / $129.34 / $165.29	Professional	26	$38.27	$129.34	$165.29
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $113.76 / $415.00 / $526.74	Professional	TC	$113.76	$415.00	$526.74
Security Health Facility/Professional Professional Modifier Low / Median / High Price $227.30 / $668.17 / $668.17	Professional		$227.30	$668.17	$668.17
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $68.20 / $80.25 / $101.54	Professional	26	$68.20	$80.25	$101.54
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $159.08 / $187.15 / $378.34	Professional	TC	$159.08	$187.15	$378.34
United Facility/Professional Professional Modifier Low / Median / High Price $114.96 / $169.13 / $451.21	Professional		$114.96	$169.13	$451.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.54 / $52.75 / $110.76	Professional	26	$29.54	$52.75	$110.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $87.15 / $124.90 / $363.74	Professional	TC	$87.15	$124.90	$363.74