Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.89 / $56.89 / $79.54	Facility	26	$56.89	$56.89	$79.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.22 / $397.95 / $1,261.80	Professional		$171.22	$397.95	$1,261.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.85 / $57.74 / $241.08	Professional	26	$33.85	$57.74	$241.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $140.87 / $337.22 / $1,099.00	Professional	TC	$140.87	$337.22	$1,099.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $259.89 / $533.20 / $1,641.78	Professional		$259.89	$533.20	$1,641.78
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.70 / $74.50 / $231.92	Professional	26	$36.70	$74.50	$231.92
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $223.20 / $460.94 / $1,409.86	Professional	TC	$223.20	$460.94	$1,409.86
CareSource Facility/Professional Professional Modifier Low / Median / High Price $49.18 / $276.43 / $325.60	Professional		$49.18	$276.43	$325.60
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.02 / $116.89 / $179.31	Facility	26	$100.02	$116.89	$179.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $335.16 / $1,205.10 / $1,369.44	Professional		$335.16	$1,205.10	$1,369.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.70 / $168.72 / $191.73	Professional	26	$47.70	$168.72	$191.73
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $306.22 / $1,036.39 / $1,177.71	Professional	TC	$306.22	$1,036.39	$1,177.71
Medica Facility/Professional Professional Modifier Low / Median / High Price $283.30 / $640.33 / $2,395.00	Professional		$283.30	$640.33	$2,395.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $40.92 / $88.96 / $719.00	Professional	26	$40.92	$88.96	$719.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $227.56 / $510.04 / $1,676.00	Professional	TC	$227.56	$510.04	$1,676.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $64.69 / $237.29 / $504.50	Professional		$64.69	$237.29	$504.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $434.53 / $634.20 / $1,146.19	Professional		$434.53	$634.20	$1,146.19
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $463.50 / $463.50 / $463.50	Facility	26	$463.50	$463.50	$463.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $399.23 / $1,346.20 / $2,395.00	Professional		$399.23	$1,346.20	$2,395.00
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $186.30 / $719.00	Professional	26	$63.10	$186.30	$719.00
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $387.64 / $1,159.90 / $1,676.00	Professional	TC	$387.64	$1,159.90	$1,676.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $914.28 / $1,654.74 / $1,654.74	Professional		$914.28	$1,654.74	$1,654.74
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $121.07 / $125.31 / $207.97	Professional	26	$121.07	$125.31	$207.97
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $289.17 / $791.31 / $1,123.04	Professional	TC	$289.17	$791.31	$1,123.04
United Facility/Professional Professional Modifier Low / Median / High Price $223.31 / $640.33 / $1,664.59	Professional		$223.31	$640.33	$1,664.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.54 / $86.82 / $175.76	Professional	26	$40.54	$86.82	$175.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $235.06 / $531.23 / $1,094.25	Professional	TC	$235.06	$531.23	$1,094.25