Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.05 / $75.08 / $75.08	Facility	26	$54.05	$75.08	$75.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $129.18 / $168.38 / $410.99	Professional		$129.18	$168.38	$410.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.31 / $49.92 / $193.00	Professional	26	$32.31	$49.92	$193.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $96.93 / $130.44 / $297.76	Professional	TC	$96.93	$130.44	$297.76
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $143.57 / $223.68 / $829.91	Professional		$143.57	$223.68	$829.91
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.86 / $56.96 / $206.81	Professional	26	$34.86	$56.96	$206.81
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $108.70 / $168.49 / $623.10	Professional	TC	$108.70	$168.49	$623.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.72 / $109.52 / $168.00	Facility	26	$93.72	$109.52	$168.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $163.95 / $517.58 / $588.16	Professional		$163.95	$517.58	$588.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.46 / $125.20 / $142.28	Professional	26	$42.46	$125.20	$142.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $121.56 / $392.38 / $445.89	Professional	TC	$121.56	$392.38	$445.89
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $161.97 / $161.97 / $161.97	Facility	26	$161.97	$161.97	$161.97
Medica Facility/Professional Professional Modifier Low / Median / High Price $159.16 / $306.23 / $968.58	Professional		$159.16	$306.23	$968.58
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $40.03 / $75.08 / $227.63	Professional	26	$40.03	$75.08	$227.63
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $119.82 / $220.53 / $740.95	Professional	TC	$119.82	$220.53	$740.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $57.01 / $153.96 / $316.99	Professional		$57.01	$153.96	$316.99
Quartz Facility/Professional Professional Modifier Low / Median / High Price $170.65 / $345.49 / $625.85	Professional		$170.65	$345.49	$625.85
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $85.05 / $161.97 / $161.97	Facility	26	$85.05	$161.97	$161.97
Quartz Facility/Professional Professional Modifier Low / Median / High Price $217.99 / $754.25 / $968.58	Professional		$217.99	$754.25	$968.58
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $52.73 / $188.00 / $227.63	Professional	26	$52.73	$188.00	$227.63
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $165.26 / $566.25 / $740.95	Professional	TC	$165.26	$566.25	$740.95
Security Health Facility/Professional Professional Modifier Low / Median / High Price $396.13 / $922.30 / $922.30	Professional		$396.13	$922.30	$922.30
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $91.02 / $109.81 / $203.73	Professional	26	$91.02	$109.81	$203.73
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $136.47 / $338.70 / $662.33	Professional	TC	$136.47	$338.70	$662.33
United Facility/Professional Professional Modifier Low / Median / High Price $158.38 / $284.63 / $661.10	Professional		$158.38	$284.63	$661.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.34 / $65.63 / $164.78	Professional	26	$39.34	$65.63	$164.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $119.82 / $216.92 / $436.01	Professional	TC	$119.82	$216.92	$436.01