Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.00 / $91.00 / $128.54	Facility	26	$91.00	$91.00	$128.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $130.69 / $212.16 / $2,133.00	Professional		$130.69	$212.16	$2,133.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.73 / $253.95 / $1,152.64	Professional	26	$59.73	$253.95	$1,152.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $68.76 / $96.47 / $389.70	Professional	TC	$68.76	$96.47	$389.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.95 / $263.83 / $766.40	Professional		$120.95	$263.83	$766.40
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.71 / $120.02 / $375.92	Professional	26	$58.71	$120.02	$375.92
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $62.24 / $142.22 / $390.46	Professional	TC	$62.24	$142.22	$390.46
CareSource Facility/Professional Professional Modifier Low / Median / High Price $79.20 / $79.31 / $158.53	Professional		$79.20	$79.31	$158.53
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $161.30 / $188.49 / $289.14	Facility	26	$161.30	$188.49	$289.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $183.24 / $563.74 / $640.61	Professional		$183.24	$563.74	$640.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $80.61 / $271.13 / $308.10	Professional	26	$80.61	$271.13	$308.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $94.69 / $292.66 / $332.56	Professional	TC	$94.69	$292.66	$332.56
Medica Facility/Professional Professional Modifier Low / Median / High Price $149.28 / $337.12 / $1,049.00	Professional		$149.28	$337.12	$1,049.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $70.48 / $157.38 / $855.01	Professional	26	$70.48	$157.38	$855.01
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $76.58 / $199.21 / $724.87	Professional	TC	$76.58	$199.21	$724.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $42.37 / $112.30 / $241.49	Professional		$42.37	$112.30	$241.49
Quartz Facility/Professional Professional Modifier Low / Median / High Price $247.00 / $370.04 / $596.60	Professional		$247.00	$370.04	$596.60
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $347.58 / $347.58 / $347.58	Facility	26	$347.58	$347.58	$347.58
Quartz Facility/Professional Professional Modifier Low / Median / High Price $210.86 / $622.00 / $1,049.00	Professional		$210.86	$622.00	$1,049.00
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $101.40 / $302.89 / $855.01	Professional	26	$101.40	$302.89	$855.01
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $109.46 / $389.19 / $724.87	Professional	TC	$109.46	$389.19	$724.87
Security Health Facility/Professional Professional Modifier Low / Median / High Price $438.45 / $774.14 / $774.14	Professional		$438.45	$774.14	$774.14
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $201.72 / $228.12 / $368.83	Professional	26	$201.72	$228.12	$368.83
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $236.73 / $269.89 / $530.02	Professional	TC	$236.73	$269.89	$530.02
United Facility/Professional Professional Modifier Low / Median / High Price $139.13 / $299.80 / $586.79	Professional		$139.13	$299.80	$586.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $68.93 / $136.91 / $285.76	Professional	26	$68.93	$136.91	$285.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $70.20 / $153.80 / $301.04	Professional	TC	$70.20	$153.80	$301.04