Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $114.30 / $158.54 / $158.54	Facility	26	$114.30	$158.54	$158.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $202.11 / $343.67 / $688.75	Professional		$202.11	$343.67	$688.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $68.17 / $115.34 / $522.34	Professional	26	$68.17	$115.34	$522.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $131.91 / $229.37 / $348.53	Professional	TC	$131.91	$229.37	$348.53
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $221.72 / $532.75 / $1,442.49	Professional		$221.72	$532.75	$1,442.49
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $73.73 / $169.90 / $478.12	Professional	26	$73.73	$169.90	$478.12
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $147.97 / $362.85 / $964.37	Professional	TC	$147.97	$362.85	$964.37
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $197.35 / $230.61 / $306.50	Facility	26	$197.35	$230.61	$306.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $298.76 / $792.12 / $900.14	Professional		$298.76	$792.12	$900.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.15 / $264.89 / $301.02	Professional	26	$90.15	$264.89	$301.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $198.30 / $527.19 / $599.08	Professional	TC	$198.30	$527.19	$599.08
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $707.68 / $707.68 / $707.68	Facility	26	$707.68	$707.68	$707.68
Medica Facility/Professional Professional Modifier Low / Median / High Price $306.67 / $884.54 / $2,372.82	Professional		$306.67	$884.54	$2,372.82
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $94.57 / $208.37 / $478.82	Professional	26	$94.57	$208.37	$478.82
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $208.31 / $673.83 / $2,126.37	Professional	TC	$208.31	$673.83	$2,126.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $73.75 / $161.48 / $424.06	Professional		$73.75	$161.48	$424.06
Quartz Facility/Professional Professional Modifier Low / Median / High Price $399.00 / $524.54 / $755.17	Professional		$399.00	$524.54	$755.17
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $179.95 / $707.68 / $707.68	Facility	26	$179.95	$707.68	$707.68
Quartz Facility/Professional Professional Modifier Low / Median / High Price $333.61 / $1,216.95 / $1,484.56	Professional		$333.61	$1,216.95	$1,484.56
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $111.57 / $394.40 / $478.82	Professional	26	$111.57	$394.40	$478.82
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $222.04 / $822.55 / $1,005.68	Professional	TC	$222.04	$822.55	$1,005.68
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,285.73 / $1,411.41 / $1,703.45	Professional		$1,285.73	$1,411.41	$1,703.45
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $384.68 / $480.85 / $571.91	Professional	26	$384.68	$480.85	$571.91
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $825.12 / $1,031.77 / $1,227.19	Professional	TC	$825.12	$1,031.77	$1,227.19
United Facility/Professional Professional Modifier Low / Median / High Price $292.07 / $746.05 / $2,372.82	Professional		$292.07	$746.05	$2,372.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $89.47 / $197.20 / $384.95	Professional	26	$89.47	$197.20	$384.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $180.16 / $517.27 / $2,126.37	Professional	TC	$180.16	$517.27	$2,126.37