Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.48 / $52.48 / $72.44	Facility	26	$52.48	$52.48	$72.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $316.23 / $549.54	Professional		$251.19	$316.23	$549.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $56.23 / $165.96	Professional	26	$30.20	$56.23	$165.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $275.42 / $489.78	Professional	TC	$213.80	$275.42	$489.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $457.09 / $1,659.59	Professional		$288.40	$457.09	$1,659.59
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $52.48 / $190.55	Professional	26	$33.88	$52.48	$190.55
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $398.11 / $1,445.44	Professional	TC	$257.04	$398.11	$1,445.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.20 / $107.15 / $169.82	Facility	26	$91.20	$107.15	$169.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $1,071.52 / $1,202.26	Professional		$446.68	$1,071.52	$1,202.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $123.03 / $141.25	Professional	26	$51.29	$123.03	$141.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $398.11 / $933.25 / $1,071.52	Professional	TC	$398.11	$933.25	$1,071.52
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $676.08 / $870.96	Professional		$575.44	$676.08	$870.96
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $79.43 / $95.50	Professional	26	$67.61	$79.43	$95.50
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $512.86 / $588.84 / $776.25	Professional	TC	$512.86	$588.84	$776.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $660.69 / $1,995.26	Professional		$354.81	$660.69	$1,995.26
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $72.44 / $218.78	Professional	26	$38.90	$72.44	$218.78
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $316.23 / $588.84 / $1,778.28	Professional	TC	$316.23	$588.84	$1,778.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $436.52	Professional		$32.36	$33.11	$436.52
Quartz Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $676.08 / $1,288.25	Professional		$457.09	$676.08	$1,288.25
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $79.43 / $218.78 / $218.78	Facility	26	$79.43	$218.78	$218.78
Quartz Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $1,621.81 / $1,995.26	Professional		$416.87	$1,621.81	$1,995.26
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $177.83 / $218.78	Professional	26	$50.12	$177.83	$218.78
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $363.08 / $1,412.54 / $1,778.28	Professional	TC	$363.08	$1,412.54	$1,778.28
Security Health Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,862.09 / $2,398.83	Professional		$794.33	$1,862.09	$2,398.83
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $95.50 / $208.93	Professional	26	$81.28	$95.50	$208.93
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $660.69 / $776.25 / $1,737.80	Professional	TC	$660.69	$776.25	$1,737.80
United Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $616.60 / $1,380.38	Professional		$338.84	$616.60	$1,380.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $67.61 / $154.88	Professional	26	$37.15	$67.61	$154.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $549.54 / $1,230.27	Professional	TC	$302.00	$549.54	$1,230.27