Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.10 / $47.26 / $57.56	Facility	26	$41.10	$47.26	$57.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.73 / $117.75 / $641.75	Professional		$56.73	$117.75	$641.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.26 / $41.10 / $232.94	Professional	26	$25.26	$41.10	$232.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.10 / $69.19 / $128.65	Professional	TC	$27.10	$69.19	$128.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.89 / $100.52 / $325.31	Professional		$56.89	$100.52	$325.31
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.52 / $42.20 / $156.61	Professional	26	$26.52	$42.20	$156.61
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.41 / $57.09 / $186.07	Professional	TC	$28.41	$57.09	$186.07
CareSource Facility/Professional Professional Modifier Low / Median / High Price $29.31 / $38.58 / $76.11	Professional		$29.31	$38.58	$76.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.09 / $84.24 / $129.22	Facility	26	$72.09	$84.24	$129.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.32 / $209.85 / $238.46	Professional		$87.32	$209.85	$238.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.47 / $95.72 / $108.78	Professional	26	$33.47	$95.72	$108.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $47.67 / $114.13 / $129.69	Professional	TC	$47.67	$114.13	$129.69
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $124.11 / $124.11 / $124.11	Facility	26	$124.11	$124.11	$124.11
Medica Facility/Professional Professional Modifier Low / Median / High Price $66.70 / $146.32 / $562.97	Professional		$66.70	$146.32	$562.97
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $31.07 / $64.92 / $186.58	Professional	26	$31.07	$64.92	$186.58
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $32.78 / $82.98 / $399.92	Professional	TC	$32.78	$82.98	$399.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.84 / $60.81 / $129.94	Professional		$25.84	$60.81	$129.94
Quartz Facility/Professional Professional Modifier Low / Median / High Price $113.59 / $172.14 / $321.02	Professional		$113.59	$172.14	$321.02
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $124.11 / $124.11	Facility	26	$100.00	$124.11	$124.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $88.38 / $342.23 / $562.97	Professional		$88.38	$342.23	$562.97
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $40.31 / $142.35 / $186.58	Professional	26	$40.31	$142.35	$186.58
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $48.07 / $245.91 / $399.92	Professional	TC	$48.07	$245.91	$399.92
Security Health Facility/Professional Professional Modifier Low / Median / High Price $167.18 / $373.92 / $373.92	Professional		$167.18	$373.92	$373.92
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $83.40 / $105.53 / $156.15	Professional	26	$83.40	$105.53	$156.15
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $83.78 / $114.74 / $457.57	Professional	TC	$83.78	$114.74	$457.57
United Facility/Professional Professional Modifier Low / Median / High Price $63.93 / $130.01 / $249.89	Professional		$63.93	$130.01	$249.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.41 / $55.52 / $124.77	Professional	26	$30.41	$55.52	$124.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.78 / $75.42 / $166.57	Professional	TC	$32.78	$75.42	$166.57