Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.95 / $24.71 / $24.71	Facility	26	$22.95	$24.71	$24.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.89 / $113.87 / $208.82	Professional		$90.89	$113.87	$208.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.74 / $15.10 / $26.40	Professional	26	$11.74	$15.10	$26.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.11 / $101.01 / $166.62	Professional	TC	$79.11	$101.01	$166.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $101.40 / $245.66 / $808.00	Professional		$101.40	$245.66	$808.00
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $27.28 / $90.21	Professional	26	$11.48	$27.28	$90.21
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $89.92 / $219.14 / $717.80	Professional	TC	$89.92	$219.14	$717.80
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.64 / $35.79 / $47.59	Facility	26	$30.64	$35.79	$47.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $142.19 / $363.23 / $412.76	Professional		$142.19	$363.23	$412.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.19 / $41.59 / $47.26	Professional	26	$12.19	$41.59	$47.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $123.69 / $321.64 / $365.51	Professional	TC	$123.69	$321.64	$365.51
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $110.80 / $110.80 / $110.80	Facility	26	$110.80	$110.80	$110.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $132.35 / $286.89 / $876.62	Professional		$132.35	$286.89	$876.62
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.94 / $30.75 / $270.04	Professional	26	$13.94	$30.75	$270.04
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $117.68 / $259.06 / $820.61	Professional	TC	$117.68	$259.06	$820.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $57.01 / $92.86 / $222.99	Professional		$57.01	$92.86	$222.99
Quartz Facility/Professional Professional Modifier Low / Median / High Price $195.00 / $255.59 / $439.22	Professional		$195.00	$255.59	$439.22
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $28.25 / $110.80 / $110.80	Facility	26	$28.25	$110.80	$110.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $152.97 / $560.52 / $876.62	Professional		$152.97	$560.52	$876.62
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $17.51 / $61.10 / $270.04	Professional	26	$17.51	$61.10	$270.04
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $135.46 / $523.08 / $820.61	Professional	TC	$135.46	$523.08	$820.61
Security Health Facility/Professional Professional Modifier Low / Median / High Price $330.76 / $624.24 / $624.24	Professional		$330.76	$624.24	$624.24
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $40.76 / $42.48 / $66.90	Professional	26	$40.76	$42.48	$66.90
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $279.52 / $328.86 / $671.73	Professional	TC	$279.52	$328.86	$671.73
United Facility/Professional Professional Modifier Low / Median / High Price $123.83 / $252.56 / $540.87	Professional		$123.83	$252.56	$540.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.33 / $28.42 / $53.56	Professional	26	$13.33	$28.42	$53.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $109.85 / $238.46 / $429.79	Professional	TC	$109.85	$238.46	$429.79