Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $75.51 / $75.51 / $106.31	Facility	26	$75.51	$75.51	$106.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.59 / $140.54 / $501.00	Professional		$95.59	$140.54	$501.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.96 / $75.51 / $253.00	Professional	26	$40.96	$75.51	$253.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $46.35 / $65.03 / $114.95	Professional	TC	$46.35	$65.03	$114.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $90.67 / $184.20 / $569.50	Professional		$90.67	$184.20	$569.50
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $48.71 / $98.88 / $307.20	Professional	26	$48.71	$98.88	$307.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $41.96 / $85.77 / $262.30	Professional	TC	$41.96	$85.77	$262.30
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $132.46 / $154.80 / $237.46	Facility	26	$132.46	$154.80	$237.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $137.69 / $423.29 / $481.01	Professional		$137.69	$423.29	$481.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.67 / $224.53 / $255.15	Professional	26	$64.67	$224.53	$255.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $64.45 / $198.75 / $225.85	Professional	TC	$64.45	$198.75	$225.85
Medica Facility/Professional Professional Modifier Low / Median / High Price $110.62 / $249.81 / $1,141.00	Professional		$110.62	$249.81	$1,141.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $54.96 / $119.68 / $493.68	Professional	26	$54.96	$119.68	$493.68
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $50.28 / $128.71 / $900.73	Professional	TC	$50.28	$128.71	$900.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.81 / $66.47 / $179.73	Professional		$28.81	$66.47	$179.73
Quartz Facility/Professional Professional Modifier Low / Median / High Price $185.90 / $278.51 / $629.42	Professional		$185.90	$278.51	$629.42
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $262.14 / $262.14 / $262.14	Facility	26	$262.14	$262.14	$262.14
Quartz Facility/Professional Professional Modifier Low / Median / High Price $158.32 / $630.87 / $1,141.00	Professional		$158.32	$630.87	$1,141.00
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $83.99 / $251.40 / $493.68	Professional	26	$83.99	$251.40	$493.68
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $74.34 / $483.37 / $900.73	Professional	TC	$74.34	$483.37	$900.73
Security Health Facility/Professional Professional Modifier Low / Median / High Price $312.26 / $581.21 / $581.21	Professional		$312.26	$581.21	$581.21
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $161.83 / $170.29 / $284.17	Professional	26	$161.83	$170.29	$284.17
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $130.57 / $145.08 / $260.52	Professional	TC	$130.57	$145.08	$260.52
United Facility/Professional Professional Modifier Low / Median / High Price $103.35 / $219.23 / $448.64	Professional		$103.35	$219.23	$448.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.76 / $114.64 / $221.40	Professional	26	$54.76	$114.64	$221.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $46.10 / $99.65 / $264.92	Professional	TC	$46.10	$99.65	$264.92