Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $95.56 / $95.56 / $95.56	Facility	26	$95.56	$95.56	$95.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $249.73 / $709.48 / $709.48	Professional		$249.73	$709.48	$709.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.56 / $257.12 / $257.12	Professional	26	$95.56	$257.12	$257.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $154.16 / $452.37 / $452.37	Professional	TC	$154.16	$452.37	$452.37
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $116.58 / $236.65 / $734.37	Professional		$116.58	$236.65	$734.37
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $43.39 / $88.08 / $278.27	Professional	26	$43.39	$88.08	$278.27
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $73.18 / $148.55 / $455.34	Professional	TC	$73.18	$148.55	$455.34
CareSource Facility/Professional Professional Modifier Low / Median / High Price $59.23 / $88.82 / $148.05	Professional		$59.23	$88.82	$148.05
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.05 / $137.94 / $211.61	Facility	26	$118.05	$137.94	$211.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.20 / $421.53 / $479.01	Professional		$194.20	$421.53	$479.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.09 / $157.32 / $178.78	Professional	26	$72.09	$157.32	$178.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $122.11 / $264.20 / $300.23	Professional	TC	$122.11	$264.20	$300.23
Medica Facility/Professional Professional Modifier Low / Median / High Price $138.11 / $313.87 / $968.53	Professional		$138.11	$313.87	$968.53
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $48.92 / $108.74 / $279.39	Professional	26	$48.92	$108.74	$279.39
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $85.03 / $200.81 / $774.95	Professional	TC	$85.03	$200.81	$774.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.36 / $107.91 / $249.95	Professional		$41.36	$107.91	$249.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $232.70 / $282.39 / $509.70	Professional		$232.70	$282.39	$509.70
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $420.16 / $420.16 / $420.16	Facility	26	$420.16	$420.16	$420.16
Quartz Facility/Professional Professional Modifier Low / Median / High Price $515.42 / $621.79 / $968.53	Professional		$515.42	$621.79	$968.53
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $192.38 / $223.60 / $279.39	Professional	26	$192.38	$223.60	$279.39
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $323.06 / $490.17 / $774.95	Professional	TC	$323.06	$490.17	$774.95
United Facility/Professional Professional Modifier Low / Median / High Price $138.11 / $296.27 / $591.41	Professional		$138.11	$296.27	$591.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.65 / $102.11 / $203.39	Professional	26	$48.65	$102.11	$203.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $85.03 / $195.74 / $415.93	Professional	TC	$85.03	$195.74	$415.93