Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $142.16 / $142.16 / $198.27	Facility	26	$142.16	$142.16	$198.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,002.74 / $1,429.56 / $1,952.12	Professional		$1,002.74	$1,429.56	$1,952.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $901.51 / $1,287.38 / $1,753.85	Professional	TC	$901.51	$1,287.38	$1,753.85
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $755.43 / $1,733.91 / $5,358.15	Professional		$755.43	$1,733.91	$5,358.15
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $658.90 / $1,561.47 / $4,839.75	Professional	TC	$658.90	$1,561.47	$4,839.75
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $249.61 / $291.69 / $447.46	Facility	26	$249.61	$291.69	$447.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $952.75 / $4,197.81 / $4,770.24	Professional		$952.75	$4,197.81	$4,770.24
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $851.91 / $3,772.98 / $4,287.47	Professional	TC	$851.91	$3,772.98	$4,287.47
Medica Facility/Professional Professional Modifier Low / Median / High Price $711.00 / $1,863.26 / $6,422.07	Professional		$711.00	$1,863.26	$6,422.07
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $597.90 / $1,641.96 / $5,800.59	Professional	TC	$597.90	$1,641.96	$5,800.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $81.30 / $706.22 / $1,737.24	Professional		$81.30	$706.22	$1,737.24
Quartz Facility/Professional Professional Modifier Low / Median / High Price $467.60 / $2,224.42 / $3,541.60	Professional		$467.60	$2,224.42	$3,541.60
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $451.11 / $451.11 / $451.11	Facility	26	$451.11	$451.11	$451.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,390.68 / $4,086.10 / $6,422.07	Professional		$1,390.68	$4,086.10	$6,422.07
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $1,249.94 / $3,628.85 / $5,800.59	Professional	TC	$1,249.94	$3,628.85	$5,800.59
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,583.37 / $5,764.24 / $5,764.24	Professional		$2,583.37	$5,764.24	$5,764.24
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $2,028.13 / $2,669.75 / $6,244.60	Professional	TC	$2,028.13	$2,669.75	$6,244.60
United Facility/Professional Professional Modifier Low / Median / High Price $834.98 / $1,560.89 / $3,581.47	Professional		$834.98	$1,560.89	$3,581.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $597.90 / $1,440.32 / $3,156.10	Professional	TC	$597.90	$1,440.32	$3,156.10