Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.24 / $63.52 / $76.73	Facility	26	$55.24	$63.52	$76.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $82.68 / $176.11 / $858.50	Professional		$82.68	$176.11	$858.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.34 / $72.09 / $344.25	Professional	26	$33.34	$72.09	$344.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $41.15 / $61.68 / $140.16	Professional	TC	$41.15	$61.68	$140.16
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.78 / $129.13 / $468.63	Professional		$81.78	$129.13	$468.63
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.64 / $59.13 / $209.40	Professional	26	$35.64	$59.13	$209.40
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $46.14 / $71.52 / $268.43	Professional	TC	$46.14	$71.52	$268.43
CareSource Facility/Professional Professional Modifier Low / Median / High Price $38.95 / $57.40 / $107.19	Professional		$38.95	$57.40	$107.19
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.32 / $113.73 / $174.46	Facility	26	$97.32	$113.73	$174.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.05 / $302.29 / $343.51	Professional		$112.05	$302.29	$343.51
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.19 / $129.13 / $146.75	Professional	26	$44.19	$129.13	$146.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $69.95 / $173.15 / $196.76	Professional	TC	$69.95	$173.15	$196.76
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $163.47 / $163.47 / $339.00	Facility	26	$163.47	$163.47	$339.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $98.50 / $206.91 / $555.44	Professional		$98.50	$206.91	$555.44
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $41.52 / $88.52 / $269.13	Professional	26	$41.52	$88.52	$269.13
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $53.21 / $110.35 / $351.46	Professional	TC	$53.21	$110.35	$351.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.84 / $64.69 / $188.51	Professional		$25.84	$64.69	$188.51
Quartz Facility/Professional Professional Modifier Low / Median / High Price $160.38 / $202.72 / $365.52	Professional		$160.38	$202.72	$365.52
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $163.47 / $163.47	Facility	26	$100.00	$163.47	$163.47
Quartz Facility/Professional Professional Modifier Low / Median / High Price $127.32 / $422.10 / $555.44	Professional		$127.32	$422.10	$555.44
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $54.39 / $190.35 / $269.13	Professional	26	$54.39	$190.35	$269.13
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $72.93 / $231.75 / $351.46	Professional	TC	$72.93	$231.75	$351.46
Security Health Facility/Professional Professional Modifier Low / Median / High Price $258.82 / $538.65 / $538.65	Professional		$258.82	$538.65	$538.65
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $113.82 / $130.47 / $212.12	Professional	26	$113.82	$130.47	$212.12
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $142.62 / $145.00 / $296.00	Professional	TC	$142.62	$145.00	$296.00
United Facility/Professional Professional Modifier Low / Median / High Price $90.29 / $177.28 / $341.90	Professional		$90.29	$177.28	$341.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.95 / $67.31 / $166.84	Professional	26	$39.95	$67.31	$166.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $52.10 / $105.68 / $203.13	Professional	TC	$52.10	$105.68	$203.13