Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.53 / $45.45 / $54.68	Facility	26	$39.53	$45.45	$54.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.14 / $122.83 / $286.36	Professional		$87.14	$122.83	$286.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.62 / $35.52 / $141.49	Professional	26	$23.62	$35.52	$141.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.32 / $84.97 / $151.63	Professional	TC	$63.32	$84.97	$151.63
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.42 / $196.68 / $545.11	Professional		$91.42	$196.68	$545.11
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.50 / $58.90 / $164.09	Professional	26	$25.50	$58.90	$164.09
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $65.16 / $144.13 / $399.29	Professional	TC	$65.16	$144.13	$399.29
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.39 / $81.08 / $107.77	Facility	26	$69.39	$81.08	$107.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.63 / $349.61 / $397.29	Professional		$100.63	$349.61	$397.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.44 / $92.04 / $104.59	Professional	26	$28.44	$92.04	$104.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $72.19 / $257.58 / $292.70	Professional	TC	$72.19	$257.58	$292.70
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $118.08 / $118.08 / $118.08	Facility	26	$118.08	$118.08	$118.08
Medica Facility/Professional Professional Modifier Low / Median / High Price $100.87 / $227.47 / $642.13	Professional		$100.87	$227.47	$642.13
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $29.94 / $68.48 / $167.46	Professional	26	$29.94	$68.48	$167.46
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $70.94 / $156.94 / $474.67	Professional	TC	$70.94	$156.94	$474.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.00 / $79.45 / $186.96	Professional		$38.00	$79.45	$186.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $121.57 / $234.27 / $375.76	Professional		$121.57	$234.27	$375.76
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $62.53 / $118.08 / $118.08	Facility	26	$62.53	$118.08	$118.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $147.24 / $459.45 / $642.13	Professional		$147.24	$459.45	$642.13
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $40.53 / $136.94 / $167.46	Professional	26	$40.53	$136.94	$167.46
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $108.48 / $322.50 / $474.67	Professional	TC	$108.48	$322.50	$474.67
Security Health Facility/Professional Professional Modifier Low / Median / High Price $547.25 / $622.91 / $643.82	Professional		$547.25	$622.91	$643.82
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $106.21 / $155.52 / $203.74	Professional	26	$106.21	$155.52	$203.74
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $136.55 / $440.22 / $513.24	Professional	TC	$136.55	$440.22	$513.24
United Facility/Professional Professional Modifier Low / Median / High Price $98.41 / $215.79 / $403.20	Professional		$98.41	$215.79	$403.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.51 / $58.89 / $120.04	Professional	26	$28.51	$58.89	$120.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $68.20 / $147.71 / $265.82	Professional	TC	$68.20	$147.71	$265.82