Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.51 / $59.51 / $84.56	Facility	26	$59.51	$59.51	$84.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.52 / $155.68 / $246.35	Professional		$52.52	$155.68	$246.35
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.49 / $58.96 / $152.29	Professional	26	$36.49	$58.96	$152.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.03 / $108.98 / $183.00	Professional	TC	$16.03	$108.98	$183.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.20 / $205.88 / $748.36	Professional		$107.20	$205.88	$748.36
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.40 / $78.48 / $245.71	Professional	26	$38.40	$78.48	$245.71
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $47.65 / $127.63 / $533.16	Professional	TC	$47.65	$127.63	$533.16
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.53 / $122.15 / $187.38	Facility	26	$104.53	$122.15	$187.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $137.51 / $613.71 / $697.40	Professional		$137.51	$613.71	$697.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.39 / $176.48 / $200.55	Professional	26	$54.39	$176.48	$200.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $89.75 / $437.23 / $496.85	Professional	TC	$89.75	$437.23	$496.85
Medica Facility/Professional Professional Modifier Low / Median / High Price $124.78 / $267.76 / $886.70	Professional		$124.78	$267.76	$886.70
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $44.83 / $104.08 / $414.43	Professional	26	$44.83	$104.08	$414.43
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $53.66 / $177.79 / $639.54	Professional	TC	$53.66	$177.79	$639.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $57.01 / $120.74 / $250.42	Professional		$57.01	$120.74	$250.42
Quartz Facility/Professional Professional Modifier Low / Median / High Price $267.14 / $324.20 / $460.43	Professional		$267.14	$324.20	$460.43
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $196.24 / $196.24 / $196.24	Facility	26	$196.24	$196.24	$196.24
Quartz Facility/Professional Professional Modifier Low / Median / High Price $203.31 / $590.27 / $886.70	Professional		$203.31	$590.27	$886.70
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $66.01 / $197.00 / $414.43	Professional	26	$66.01	$197.00	$414.43
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $144.85 / $420.53 / $639.54	Professional	TC	$144.85	$420.53	$639.54
Security Health Facility/Professional Professional Modifier Low / Median / High Price $306.68 / $842.72 / $842.72	Professional		$306.68	$842.72	$842.72
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $131.46 / $151.01 / $250.81	Professional	26	$131.46	$151.01	$250.81
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $55.87 / $192.08 / $426.74	Professional	TC	$55.87	$192.08	$426.74
United Facility/Professional Professional Modifier Low / Median / High Price $123.07 / $234.52 / $498.36	Professional		$123.07	$234.52	$498.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.83 / $84.68 / $185.85	Professional	26	$44.83	$84.68	$185.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $81.90 / $150.88 / $333.37	Professional	TC	$81.90	$150.88	$333.37