Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.65 / $34.25 / $34.25	Facility	26	$24.65	$34.25	$34.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.59 / $49.25 / $96.48	Professional		$37.59	$49.25	$96.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.08 / $17.32 / $34.94	Professional	26	$14.08	$17.32	$34.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.51 / $34.15 / $92.92	Professional	TC	$23.51	$34.15	$92.92
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.39 / $90.95 / $255.40	Professional		$41.39	$90.95	$255.40
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.90 / $36.44 / $102.31	Professional	26	$15.90	$36.44	$102.31
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.83 / $57.97 / $166.02	Professional	TC	$23.83	$57.97	$166.02
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.25 / $50.55 / $67.18	Facility	26	$43.25	$50.55	$67.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.86 / $164.73 / $187.19	Professional		$58.86	$164.73	$187.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.89 / $57.67 / $65.54	Professional	26	$16.89	$57.67	$65.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.99 / $107.10 / $121.70	Professional	TC	$38.99	$107.10	$121.70
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $80.00 / $80.00 / $80.00	Facility	26	$80.00	$80.00	$80.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $47.09 / $110.28 / $301.08	Professional		$47.09	$110.28	$301.08
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $18.48 / $42.30 / $104.20	Professional	26	$18.48	$42.30	$104.20
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $28.88 / $70.64 / $196.89	Professional	TC	$28.88	$70.64	$196.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.71 / $46.32 / $75.18	Professional		$19.71	$46.32	$75.18
Quartz Facility/Professional Professional Modifier Low / Median / High Price $75.43 / $109.64 / $159.06	Professional		$75.43	$109.64	$159.06
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $39.18 / $80.00 / $80.00	Facility	26	$39.18	$80.00	$80.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $69.38 / $220.55 / $301.08	Professional		$69.38	$220.55	$301.08
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $25.53 / $84.70 / $104.20	Professional	26	$25.53	$84.70	$104.20
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $45.10 / $135.85 / $196.89	Professional	TC	$45.10	$135.85	$196.89
Security Health Facility/Professional Professional Modifier Low / Median / High Price $157.44 / $293.52 / $293.52	Professional		$157.44	$293.52	$293.52
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $51.59 / $96.94 / $121.28	Professional	26	$51.59	$96.94	$121.28
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $97.10 / $152.80 / $193.34	Professional	TC	$97.10	$152.80	$193.34
United Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $101.61 / $193.31	Professional		$46.77	$101.61	$193.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.73 / $38.79 / $74.33	Professional	26	$17.73	$38.79	$74.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.88 / $63.97 / $119.07	Professional	TC	$28.88	$63.97	$119.07