Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.42 / $36.13 / $43.65	Facility	26	$31.42	$36.13	$43.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.73 / $74.03 / $136.53	Professional		$56.73	$74.03	$136.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.73 / $21.75 / $44.41	Professional	26	$18.73	$21.75	$44.41
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $37.99 / $49.34 / $87.65	Professional	TC	$37.99	$49.34	$87.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $62.87 / $138.21 / $400.38	Professional		$62.87	$138.21	$400.38
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.27 / $46.84 / $130.49	Professional	26	$20.27	$46.84	$130.49
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $42.60 / $88.04 / $255.03	Professional	TC	$42.60	$88.04	$255.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.97 / $64.23 / $85.37	Facility	26	$54.97	$64.23	$85.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.05 / $229.79 / $261.13	Professional		$72.05	$229.79	$261.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.60 / $73.45 / $83.48	Professional	26	$23.60	$73.45	$83.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $48.01 / $156.33 / $177.65	Professional	TC	$48.01	$156.33	$177.65
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $94.47 / $94.47 / $94.47	Facility	26	$94.47	$94.47	$94.47
Medica Facility/Professional Professional Modifier Low / Median / High Price $68.09 / $155.71 / $420.07	Professional		$68.09	$155.71	$420.07
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $24.81 / $56.44 / $132.09	Professional	26	$24.81	$56.44	$132.09
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $43.09 / $101.81 / $288.04	Professional	TC	$43.09	$101.81	$288.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.71 / $48.50 / $85.00	Professional		$19.71	$48.50	$85.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $81.29 / $154.60 / $276.20	Professional		$81.29	$154.60	$276.20
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $49.90 / $94.47 / $94.47	Facility	26	$49.90	$94.47	$94.47
Quartz Facility/Professional Professional Modifier Low / Median / High Price $100.36 / $305.45 / $420.07	Professional		$100.36	$305.45	$420.07
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $32.03 / $109.65 / $132.09	Professional	26	$32.03	$109.65	$132.09
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $67.98 / $195.80 / $288.04	Professional	TC	$67.98	$195.80	$288.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $394.79 / $409.45 / $475.51	Professional		$394.79	$409.45	$475.51
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $84.97 / $123.68 / $171.28	Professional	26	$84.97	$123.68	$171.28
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $97.10 / $273.47 / $314.39	Professional	TC	$97.10	$273.47	$314.39
United Facility/Professional Professional Modifier Low / Median / High Price $65.14 / $140.72 / $267.73	Professional		$65.14	$140.72	$267.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.93 / $47.15 / $96.11	Professional	26	$23.93	$47.15	$96.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $41.50 / $97.90 / $182.63	Professional	TC	$41.50	$97.90	$182.63