Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.38 / $68.36 / $69.13	Facility	26	$49.38	$68.36	$69.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.07 / $185.67 / $778.62	Professional		$101.07	$185.67	$778.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.27 / $69.23 / $278.35	Professional	26	$30.27	$69.23	$278.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $65.50 / $109.44 / $431.00	Professional	TC	$65.50	$109.44	$431.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.46 / $158.82 / $599.48	Professional		$102.46	$158.82	$599.48
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.86 / $51.92 / $186.52	Professional	26	$31.86	$51.92	$186.52
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $70.61 / $109.44 / $412.97	Professional	TC	$70.61	$109.44	$412.97
CareSource Facility/Professional Professional Modifier Low / Median / High Price $34.79 / $80.54 / $129.55	Professional		$34.79	$80.54	$129.55
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.61 / $100.04 / $153.46	Facility	26	$85.61	$100.04	$153.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $126.95 / $371.03 / $421.63	Professional		$126.95	$371.03	$421.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.60 / $113.86 / $129.38	Professional	26	$39.60	$113.86	$129.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $83.08 / $257.17 / $292.24	Professional	TC	$83.08	$257.17	$292.24
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $171.00 / $171.00 / $374.43	Facility	26	$171.00	$171.00	$374.43
Medica Facility/Professional Professional Modifier Low / Median / High Price $118.20 / $260.14 / $687.27	Professional		$118.20	$260.14	$687.27
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $36.90 / $84.53 / $254.27	Professional	26	$36.90	$84.53	$254.27
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $79.59 / $157.52 / $479.00	Professional	TC	$79.59	$157.52	$479.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.36 / $98.65 / $191.96	Professional		$41.36	$98.65	$191.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $195.97 / $298.93 / $471.00	Professional		$195.97	$298.93	$471.00
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $171.00 / $171.00	Facility	26	$100.00	$171.00	$171.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $156.27 / $530.95 / $687.27	Professional		$156.27	$530.95	$687.27
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $47.96 / $169.05 / $254.27	Professional	26	$47.96	$169.05	$254.27
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $108.31 / $361.90 / $479.00	Professional	TC	$108.31	$361.90	$479.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $284.16 / $661.11 / $661.11	Professional		$284.16	$661.11	$661.11
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $100.45 / $121.38 / $185.20	Professional	26	$100.45	$121.38	$185.20
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $151.72 / $215.25 / $517.69	Professional	TC	$151.72	$215.25	$517.69
United Facility/Professional Professional Modifier Low / Median / High Price $113.04 / $203.44 / $408.83	Professional		$113.04	$203.44	$408.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.61 / $95.00 / $207.85	Professional	26	$39.61	$95.00	$207.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $76.98 / $136.13 / $293.14	Professional	TC	$76.98	$136.13	$293.14