Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.40 / $63.40 / $320.10	Facility	26	$63.40	$63.40	$320.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $411.83 / $606.96 / $2,628.51	Professional		$411.83	$606.96	$2,628.51
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.29 / $89.08 / $314.50	Professional	26	$40.29	$89.08	$314.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $375.12 / $448.71 / $1,031.84	Professional	TC	$375.12	$448.71	$1,031.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $391.58 / $655.75 / $2,211.71	Professional		$391.58	$655.75	$2,211.71
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $40.90 / $63.40 / $230.17	Professional	26	$40.90	$63.40	$230.17
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $350.68 / $558.57 / $2,010.43	Professional	TC	$350.68	$558.57	$2,010.43
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $109.94 / $124.93 / $197.08	Facility	26	$109.94	$124.93	$197.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $559.22 / $1,396.11 / $1,586.49	Professional		$559.22	$1,396.11	$1,586.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.66 / $147.06 / $167.11	Professional	26	$60.66	$147.06	$167.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $500.02 / $1,249.05 / $1,419.38	Professional	TC	$500.02	$1,249.05	$1,419.38
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $848.67 / $848.67 / $848.67	Facility	26	$848.67	$848.67	$848.67
Medica Facility/Professional Professional Modifier Low / Median / High Price $473.37 / $920.80 / $2,679.53	Professional		$473.37	$920.80	$2,679.53
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $48.09 / $100.52 / $266.22	Professional	26	$48.09	$100.52	$266.22
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $425.26 / $830.20 / $2,413.31	Professional	TC	$425.26	$830.20	$2,413.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $316.92 / $748.63	Professional		$65.00	$316.92	$748.63
Quartz Facility/Professional Professional Modifier Low / Median / High Price $759.20 / $921.32 / $1,598.85	Professional		$759.20	$921.32	$1,598.85
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $189.21 / $189.21 / $189.21	Facility	26	$189.21	$189.21	$189.21
Quartz Facility/Professional Professional Modifier Low / Median / High Price $588.01 / $2,165.50 / $2,679.53	Professional		$588.01	$2,165.50	$2,679.53
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $61.93 / $220.10 / $266.22	Professional	26	$61.93	$220.10	$266.22
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $526.07 / $1,945.40 / $2,413.31	Professional	TC	$526.07	$1,945.40	$2,413.31
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,071.71 / $2,487.69 / $2,487.69	Professional		$1,071.71	$2,487.69	$2,487.69
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $116.66 / $147.61 / $248.03	Professional	26	$116.66	$147.61	$248.03
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $913.00 / $1,074.11 / $2,664.36	Professional	TC	$913.00	$1,074.11	$2,664.36
United Facility/Professional Professional Modifier Low / Median / High Price $457.41 / $920.80 / $1,898.06	Professional		$457.41	$920.80	$1,898.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.09 / $82.52 / $192.92	Professional	26	$48.09	$82.52	$192.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $411.43 / $812.04 / $1,705.14	Professional	TC	$411.43	$812.04	$1,705.14