Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.00 / $52.00 / $72.23	Facility	26	$52.00	$52.00	$72.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $300.52 / $340.39 / $534.14	Professional		$300.52	$340.39	$534.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.35 / $52.36 / $205.83	Professional	26	$33.35	$52.36	$205.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $270.12 / $312.10 / $481.78	Professional	TC	$270.12	$312.10	$481.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $291.52 / $485.04 / $1,643.83	Professional		$291.52	$485.04	$1,643.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.54 / $52.00 / $189.46	Professional	26	$33.54	$52.00	$189.46
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $257.97 / $408.22 / $1,476.42	Professional	TC	$257.97	$408.22	$1,476.42
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.01 / $103.42 / $163.15	Facility	26	$91.01	$103.42	$163.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $416.52 / $1,040.38 / $1,182.25	Professional		$416.52	$1,040.38	$1,182.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.76 / $121.59 / $138.18	Professional	26	$49.76	$121.59	$138.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $366.76 / $918.83 / $1,044.13	Professional	TC	$366.76	$918.83	$1,044.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $350.64 / $673.04 / $1,991.14	Professional		$350.64	$673.04	$1,991.14
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $39.25 / $75.18 / $218.97	Professional	26	$39.25	$75.18	$218.97
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $311.33 / $597.86 / $1,772.11	Professional	TC	$311.33	$597.86	$1,772.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $244.53 / $564.07	Professional		$65.00	$244.53	$564.07
Quartz Facility/Professional Professional Modifier Low / Median / High Price $565.50 / $686.26 / $1,167.99	Professional		$565.50	$686.26	$1,167.99
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $155.94 / $155.94 / $155.94	Facility	26	$155.94	$155.94	$155.94
Quartz Facility/Professional Professional Modifier Low / Median / High Price $438.19 / $1,604.05 / $1,991.14	Professional		$438.19	$1,604.05	$1,991.14
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $51.21 / $179.80 / $218.97	Professional	26	$51.21	$179.80	$218.97
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $386.98 / $1,424.25 / $1,772.11	Professional	TC	$386.98	$1,424.25	$1,772.11
Security Health Facility/Professional Professional Modifier Low / Median / High Price $790.13 / $1,853.86 / $1,853.86	Professional		$790.13	$1,853.86	$1,853.86
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $81.25 / $95.59 / $205.45	Professional	26	$81.25	$95.59	$205.45
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $664.98 / $782.33 / $1,945.67	Professional	TC	$664.98	$782.33	$1,945.67
United Facility/Professional Professional Modifier Low / Median / High Price $346.62 / $732.54 / $1,405.95	Professional		$346.62	$732.54	$1,405.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.25 / $69.95 / $157.59	Professional	26	$39.25	$69.95	$157.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $299.69 / $591.44 / $1,248.35	Professional	TC	$299.69	$591.44	$1,248.35