Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $154.13 / $154.13 / $218.84	Facility	26	$154.13	$154.13	$218.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $293.74 / $449.47 / $627.50	Professional		$293.74	$449.47	$627.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.57 / $124.24 / $213.88	Professional	26	$89.57	$124.24	$213.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $204.15 / $270.70 / $362.93	Professional	TC	$204.15	$270.70	$362.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $323.20 / $681.94 / $2,292.92	Professional		$323.20	$681.94	$2,292.92
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $99.45 / $203.64 / $688.99	Professional	26	$99.45	$203.64	$688.99
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $221.92 / $476.82 / $1,603.94	Professional	TC	$221.92	$476.82	$1,603.94
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $272.14 / $318.02 / $487.84	Facility	26	$272.14	$318.02	$487.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $429.58 / $1,556.94 / $1,769.25	Professional		$429.58	$1,556.94	$1,769.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $133.04 / $459.88 / $522.59	Professional	26	$133.04	$459.88	$522.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $297.49 / $1,097.11 / $1,246.73	Professional	TC	$297.49	$1,097.11	$1,246.73
Medica Facility/Professional Professional Modifier Low / Median / High Price $362.91 / $776.18 / $2,193.48	Professional		$362.91	$776.18	$2,193.48
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $116.60 / $245.07 / $640.52	Professional	26	$116.60	$245.07	$640.52
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $246.31 / $532.48 / $1,552.95	Professional	TC	$246.31	$532.48	$1,552.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $80.83 / $206.27 / $618.46	Professional		$80.83	$206.27	$618.46
Quartz Facility/Professional Professional Modifier Low / Median / High Price $425.07 / $827.45 / $1,480.83	Professional		$425.07	$827.45	$1,480.83
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $469.26 / $469.26 / $469.26	Facility	26	$469.26	$469.26	$469.26
Quartz Facility/Professional Professional Modifier Low / Median / High Price $515.79 / $1,631.80 / $2,193.48	Professional		$515.79	$1,631.80	$2,193.48
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $152.34 / $512.35 / $640.52	Professional	26	$152.34	$512.35	$640.52
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $363.45 / $1,119.40 / $1,552.95	Professional	TC	$363.45	$1,119.40	$1,552.95
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,072.41 / $2,137.92 / $2,137.92	Professional		$1,072.41	$2,137.92	$2,137.92
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $290.43 / $341.68 / $472.91	Professional	26	$290.43	$341.68	$472.91
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $621.12 / $730.73 / $1,115.63	Professional	TC	$621.12	$730.73	$1,115.63
United Facility/Professional Professional Modifier Low / Median / High Price $356.71 / $652.72 / $1,443.54	Professional		$356.71	$652.72	$1,443.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $111.53 / $233.98 / $483.35	Professional	26	$111.53	$233.98	$483.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $244.71 / $506.12 / $991.18	Professional	TC	$244.71	$506.12	$991.18