Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.03 / $74.81 / $75.64	Facility	26	$54.03	$74.81	$75.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.53 / $264.61 / $637.92	Professional		$97.53	$264.61	$637.92
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.27 / $126.38 / $356.25	Professional	26	$34.27	$126.38	$356.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $51.16 / $85.49 / $504.00	Professional	TC	$51.16	$85.49	$504.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $90.01 / $139.52 / $511.33	Professional		$90.01	$139.52	$511.33
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.86 / $56.99 / $203.55	Professional	26	$34.86	$56.99	$203.55
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $55.16 / $85.49 / $311.42	Professional	TC	$55.16	$85.49	$311.42
CareSource Facility/Professional Professional Modifier Low / Median / High Price $38.04 / $65.34 / $114.27	Professional		$38.04	$65.34	$114.27
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $94.62 / $110.57 / $169.61	Facility	26	$94.62	$110.57	$169.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $113.77 / $326.80 / $371.36	Professional		$113.77	$326.80	$371.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.98 / $125.94 / $143.11	Professional	26	$42.98	$125.94	$143.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $71.06 / $200.86 / $228.25	Professional	TC	$71.06	$200.86	$228.25
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $163.00 / $163.00 / $691.00	Facility	26	$163.00	$163.00	$691.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $104.89 / $233.30 / $600.27	Professional		$104.89	$233.30	$600.27
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $40.36 / $94.13 / $233.19	Professional	26	$40.36	$94.13	$233.19
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $62.15 / $127.54 / $372.64	Professional	TC	$62.15	$127.54	$372.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.36 / $94.25 / $191.96	Professional		$41.36	$94.25	$191.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $129.60 / $216.92 / $395.16	Professional		$129.60	$216.92	$395.16
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $163.00 / $163.00	Facility	26	$100.00	$163.00	$163.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $137.63 / $464.75 / $600.27	Professional		$137.63	$464.75	$600.27
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $53.03 / $185.05 / $233.19	Professional	26	$53.03	$185.05	$233.19
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $84.61 / $279.70 / $372.64	Professional	TC	$84.61	$279.70	$372.64
Security Health Facility/Professional Professional Modifier Low / Median / High Price $257.93 / $582.30 / $582.30	Professional		$257.93	$582.30	$582.30
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $110.24 / $206.33	Professional	26	$75.86	$110.24	$206.33
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $169.09 / $182.07 / $371.15	Professional	TC	$169.09	$182.07	$371.15
United Facility/Professional Professional Modifier Low / Median / High Price $99.22 / $171.07 / $381.10	Professional		$99.22	$171.07	$381.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.51 / $126.34 / $284.72	Professional	26	$61.51	$126.34	$284.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $73.00 / $100.00 / $402.62	Professional	TC	$73.00	$100.00	$402.62