Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.63 / $55.63 / $77.27	Facility	26	$55.63	$55.63	$77.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $265.48 / $459.47 / $1,793.50	Professional		$265.48	$459.47	$1,793.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.20 / $55.63 / $348.50	Professional	26	$33.20	$55.63	$348.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $218.71 / $299.66 / $488.29	Professional	TC	$218.71	$299.66	$488.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $296.43 / $491.78 / $1,671.21	Professional		$296.43	$491.78	$1,671.21
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.89 / $56.65 / $200.47	Professional	26	$35.89	$56.65	$200.47
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $260.54 / $435.13 / $1,470.74	Professional	TC	$260.54	$435.13	$1,470.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.42 / $109.57 / $172.85	Facility	26	$96.42	$109.57	$172.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $424.95 / $1,058.64 / $1,203.00	Professional		$424.95	$1,058.64	$1,203.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.23 / $128.88 / $146.44	Professional	26	$53.23	$128.88	$146.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $371.72 / $929.75 / $1,056.54	Professional	TC	$371.72	$929.75	$1,056.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $312.88 / $631.92 / $2,023.55	Professional		$312.88	$631.92	$2,023.55
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $42.03 / $84.55 / $267.48	Professional	26	$42.03	$84.55	$267.48
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $271.27 / $552.79 / $1,789.49	Professional	TC	$271.27	$552.79	$1,789.49
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 $428.76 / $700.45 / $1,008.41	Professional		$428.76	$700.45	$1,008.41
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $168.00 / $168.00 / $168.00	Facility	26	$168.00	$168.00	$168.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $445.88 / $1,628.45 / $2,023.55	Professional		$445.88	$1,628.45	$2,023.55
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $54.28 / $192.25 / $267.48	Professional	26	$54.28	$192.25	$267.48
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $391.60 / $1,436.25 / $1,789.49	Professional	TC	$391.60	$1,436.25	$1,789.49
Security Health Facility/Professional Professional Modifier Low / Median / High Price $803.39 / $1,886.39 / $1,886.39	Professional		$803.39	$1,886.39	$1,886.39
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $102.16 / $129.26 / $211.56	Professional	26	$102.16	$129.26	$211.56
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $671.93 / $790.50 / $1,429.06	Professional	TC	$671.93	$790.50	$1,429.06
United Facility/Professional Professional Modifier Low / Median / High Price $312.88 / $592.42 / $1,427.34	Professional		$312.88	$592.42	$1,427.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.96 / $77.22 / $168.51	Professional	26	$41.96	$77.22	$168.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $272.07 / $463.15 / $1,381.22	Professional	TC	$272.07	$463.15	$1,381.22