Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.91 / $25.19 / $29.75	Facility	26	$21.91	$25.19	$29.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.01 / $61.59 / $179.90	Professional		$45.01	$61.59	$179.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.03 / $17.07 / $72.80	Professional	26	$13.03	$17.07	$72.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $31.97 / $44.55 / $74.80	Professional	TC	$31.97	$44.55	$74.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.98 / $113.50 / $312.08	Professional		$49.98	$113.50	$312.08
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.14 / $32.65 / $90.98	Professional	26	$14.14	$32.65	$90.98
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $35.84 / $80.84 / $221.10	Professional	TC	$35.84	$80.84	$221.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.95 / $43.17 / $57.38	Facility	26	$36.95	$43.17	$57.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.28 / $186.85 / $212.33	Professional		$63.28	$186.85	$212.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.96 / $50.05 / $56.88	Professional	26	$16.96	$50.05	$56.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $46.45 / $136.80 / $155.44	Professional	TC	$46.45	$136.80	$155.44
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $70.00 / $70.00 / $235.87	Facility	26	$70.00	$70.00	$235.87
Medica Facility/Professional Professional Modifier Low / Median / High Price $54.74 / $135.97 / $325.58	Professional		$54.74	$135.97	$325.58
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $16.00 / $38.86 / $91.83	Professional	26	$16.00	$38.86	$91.83
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $38.97 / $97.32 / $233.75	Professional	TC	$38.97	$97.32	$233.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.71 / $46.43 / $77.04	Professional		$19.71	$46.43	$77.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $105.30 / $127.79 / $225.93	Professional		$105.30	$127.79	$225.93
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $34.00 / $70.00 / $70.00	Facility	26	$34.00	$70.00	$70.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $81.01 / $257.35 / $325.58	Professional		$81.01	$257.35	$325.58
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $21.52 / $73.55 / $91.83	Professional	26	$21.52	$73.55	$91.83
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $58.32 / $183.80 / $233.75	Professional	TC	$58.32	$183.80	$233.75
Security Health Facility/Professional Professional Modifier Low / Median / High Price $329.89 / $332.99 / $412.36	Professional		$329.89	$332.99	$412.36
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $68.97 / $104.27 / $115.93	Professional	26	$68.97	$104.27	$115.93
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $170.67 / $279.81 / $296.72	Professional	TC	$170.67	$279.81	$296.72
United Facility/Professional Professional Modifier Low / Median / High Price $54.13 / $117.53 / $225.57	Professional		$54.13	$117.53	$225.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.45 / $33.93 / $64.47	Professional	26	$15.45	$33.93	$64.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $87.68 / $161.10	Professional	TC	$38.90	$87.68	$161.10