Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.63 / $49.02 / $59.69	Facility	26	$42.63	$49.02	$59.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.75 / $133.53 / $220.37	Professional		$91.75	$133.53	$220.37
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.68 / $35.94 / $127.50	Professional	26	$25.68	$35.94	$127.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $65.23 / $88.60 / $145.38	Professional	TC	$65.23	$88.60	$145.38
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.69 / $180.73 / $587.08	Professional		$100.69	$180.73	$587.08
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.50 / $44.91 / $161.00	Professional	26	$27.50	$44.91	$161.00
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $73.18 / $124.62 / $426.09	Professional	TC	$73.18	$124.62	$426.09
CareSource Facility/Professional Professional Modifier Low / Median / High Price $30.37 / $86.14 / $130.19	Professional		$30.37	$86.14	$130.19
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.79 / $87.40 / $134.08	Facility	26	$74.79	$87.40	$134.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.13 / $366.98 / $417.03	Professional		$128.13	$366.98	$417.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.47 / $99.29 / $112.83	Professional	26	$35.47	$99.29	$112.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $92.64 / $267.70 / $304.20	Professional	TC	$92.64	$267.70	$304.20
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $128.65 / $128.65 / $128.65	Facility	26	$128.65	$128.65	$128.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $110.87 / $211.73 / $674.54	Professional		$110.87	$211.73	$674.54
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $31.85 / $59.24 / $180.38	Professional	26	$31.85	$59.24	$180.38
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $79.81 / $151.81 / $494.15	Professional	TC	$79.81	$151.81	$494.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.69 / $107.91 / $253.57	Professional		$38.69	$107.91	$253.57
Quartz Facility/Professional Professional Modifier Low / Median / High Price $162.02 / $250.05 / $359.99	Professional		$162.02	$250.05	$359.99
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $67.45 / $128.65 / $128.65	Facility	26	$67.45	$128.65	$128.65
Quartz Facility/Professional Professional Modifier Low / Median / High Price $154.57 / $492.00 / $674.54	Professional		$154.57	$492.00	$674.54
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $41.82 / $138.62 / $180.38	Professional	26	$41.82	$138.62	$180.38
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $112.75 / $353.38 / $494.15	Professional	TC	$112.75	$353.38	$494.15
Security Health Facility/Professional Professional Modifier Low / Median / High Price $275.52 / $653.91 / $653.91	Professional		$275.52	$653.91	$653.91
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $72.97 / $85.85 / $108.63	Professional	26	$72.97	$85.85	$108.63
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $187.24 / $220.28 / $278.72	Professional	TC	$187.24	$220.28	$278.72
United Facility/Professional Professional Modifier Low / Median / High Price $109.71 / $197.01 / $435.29	Professional		$109.71	$197.01	$435.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.40 / $95.00 / $179.41	Professional	26	$36.40	$95.00	$179.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $79.39 / $140.28 / $307.99	Professional	TC	$79.39	$140.28	$307.99