Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.81 / $68.81 / $97.72	Facility	26	$68.81	$68.81	$97.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.57 / $95.13 / $232.20	Professional		$55.57	$95.13	$232.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.99 / $68.13 / $231.00	Professional	26	$37.99	$68.13	$231.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.57 / $26.98 / $36.13	Professional	TC	$17.57	$26.98	$36.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $62.53 / $126.93 / $393.36	Professional		$62.53	$126.93	$393.36
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $44.39 / $90.11 / $281.45	Professional	26	$44.39	$90.11	$281.45
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.13 / $36.79 / $111.90	Professional	TC	$18.13	$36.79	$111.90
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $121.65 / $142.16 / $218.08	Facility	26	$121.65	$142.16	$218.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.64 / $291.58 / $331.34	Professional		$84.64	$291.58	$331.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.15 / $206.10 / $234.20	Professional	26	$59.15	$206.10	$234.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.49 / $85.48 / $97.14	Professional	TC	$25.49	$85.48	$97.14
Medica Facility/Professional Professional Modifier Low / Median / High Price $71.81 / $153.54 / $404.61	Professional		$71.81	$153.54	$404.61
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $50.14 / $108.95 / $402.86	Professional	26	$50.14	$108.95	$402.86
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $19.75 / $47.01 / $402.86	Professional	TC	$19.75	$47.01	$402.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.13 / $59.03 / $127.26	Professional		$25.13	$59.03	$127.26
Quartz Facility/Professional Professional Modifier Low / Median / High Price $94.85 / $155.38 / $277.32	Professional		$94.85	$155.38	$277.32
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $210.41 / $210.41 / $210.41	Facility	26	$210.41	$210.41	$210.41
Quartz Facility/Professional Professional Modifier Low / Median / High Price $109.06 / $318.55 / $404.61	Professional		$109.06	$318.55	$404.61
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $77.09 / $228.95 / $402.86	Professional	26	$77.09	$228.95	$402.86
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $31.97 / $89.65 / $402.86	Professional	TC	$31.97	$89.65	$402.86
Security Health Facility/Professional Professional Modifier Low / Median / High Price $215.48 / $400.43 / $400.43	Professional		$215.48	$400.43	$400.43
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $148.75 / $157.44 / $259.19	Professional	26	$148.75	$157.44	$259.19
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $56.55 / $62.83 / $112.60	Professional	TC	$56.55	$62.83	$112.60
United Facility/Professional Professional Modifier Low / Median / High Price $69.77 / $137.76 / $300.52	Professional		$69.77	$137.76	$300.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.81 / $104.40 / $202.37	Professional	26	$49.81	$104.40	$202.37
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.75 / $42.02 / $82.18	Professional	TC	$19.75	$42.02	$82.18