Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.11 / $36.97 / $36.97	Facility	26	$26.11	$36.97	$36.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.95 / $125.55 / $210.74	Professional		$86.95	$125.55	$210.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.43 / $26.11 / $168.02	Professional	26	$16.43	$26.11	$168.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $71.26 / $107.15 / $148.97	Professional	TC	$71.26	$107.15	$148.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $90.98 / $205.04 / $585.51	Professional		$90.98	$205.04	$585.51
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.84 / $39.64 / $111.73	Professional	26	$16.84	$39.64	$111.73
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $73.95 / $163.43 / $452.92	Professional	TC	$73.95	$163.43	$452.92
CareSource Facility/Professional Professional Modifier Low / Median / High Price $20.63 / $91.70 / $193.84	Professional		$20.63	$91.70	$193.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.06 / $52.65 / $69.98	Facility	26	$45.06	$52.65	$69.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.27 / $316.11 / $392.28	Professional		$100.27	$316.11	$392.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.68 / $61.05 / $69.38	Professional	26	$19.68	$61.05	$69.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $80.81 / $261.08 / $322.85	Professional	TC	$80.81	$261.08	$322.85
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $81.76 / $81.76 / $81.76	Facility	26	$81.76	$81.76	$81.76
Medica Facility/Professional Professional Modifier Low / Median / High Price $102.68 / $213.34 / $664.33	Professional		$102.68	$213.34	$664.33
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $20.72 / $47.27 / $113.72	Professional	26	$20.72	$47.27	$113.72
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $81.86 / $174.81 / $550.61	Professional	TC	$81.86	$174.81	$550.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.42 / $70.00 / $158.69	Professional		$39.42	$70.00	$158.69
Quartz Facility/Professional Professional Modifier Low / Median / High Price $124.51 / $230.47 / $360.95	Professional		$124.51	$230.47	$360.95
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $41.48 / $81.76 / $81.76	Facility	26	$41.48	$81.76	$81.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $145.38 / $463.05 / $664.33	Professional		$145.38	$463.05	$664.33
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $25.72 / $90.85 / $113.72	Professional	26	$25.72	$90.85	$113.72
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $119.66 / $372.20 / $550.61	Professional	TC	$119.66	$372.20	$550.61
Security Health Facility/Professional Professional Modifier Low / Median / High Price $109.24 / $615.11 / $615.11	Professional		$109.24	$615.11	$615.11
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.82 / $37.21 / $101.99	Professional	26	$18.82	$37.21	$101.99
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $72.83 / $126.00 / $566.52	Professional	TC	$72.83	$126.00	$566.52
United Facility/Professional Professional Modifier Low / Median / High Price $101.22 / $203.40 / $383.78	Professional		$101.22	$203.40	$383.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.13 / $41.44 / $79.63	Professional	26	$19.13	$41.44	$79.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $78.67 / $170.47 / $326.23	Professional	TC	$78.67	$170.47	$326.23