Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $71.70 / $71.70 / $99.59	Facility	26	$71.70	$71.70	$99.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $278.75 / $362.09 / $2,051.82	Professional		$278.75	$362.09	$2,051.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.47 / $71.70 / $285.04	Professional	26	$43.47	$71.70	$285.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $223.84 / $305.89 / $495.22	Professional	TC	$223.84	$305.89	$495.22
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $310.99 / $508.83 / $1,750.61	Professional		$310.99	$508.83	$1,750.61
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $46.26 / $73.20 / $258.64	Professional	26	$46.26	$73.20	$258.64
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $264.73 / $435.63 / $1,493.97	Professional	TC	$264.73	$435.63	$1,493.97
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $125.26 / $142.34 / $224.54	Facility	26	$125.26	$142.34	$224.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $445.60 / $1,110.67 / $1,262.13	Professional		$445.60	$1,110.67	$1,262.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $68.59 / $166.86 / $189.61	Professional	26	$68.59	$166.86	$189.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $377.00 / $943.86 / $1,072.56	Professional	TC	$377.00	$943.86	$1,072.56
Medica Facility/Professional Professional Modifier Low / Median / High Price $358.68 / $666.37 / $2,116.12	Professional		$358.68	$666.37	$2,116.12
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $54.34 / $111.27 / $350.03	Professional	26	$54.34	$111.27	$350.03
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $304.38 / $578.60 / $1,817.68	Professional	TC	$304.38	$578.60	$1,817.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.14 / $244.53 / $564.07	Professional		$65.14	$244.53	$564.07
Quartz Facility/Professional Professional Modifier Low / Median / High Price $604.50 / $733.58 / $1,341.70	Professional		$604.50	$733.58	$1,341.70
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $216.00 / $216.00 / $216.00	Facility	26	$216.00	$216.00	$216.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $467.79 / $1,695.10 / $2,116.12	Professional		$467.79	$1,695.10	$2,116.12
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $70.27 / $248.60 / $350.03	Professional	26	$70.27	$248.60	$350.03
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $397.52 / $1,446.50 / $1,817.68	Professional	TC	$397.52	$1,446.50	$1,817.68
Security Health Facility/Professional Professional Modifier Low / Median / High Price $826.70 / $1,979.12 / $1,979.12	Professional		$826.70	$1,979.12	$1,979.12
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $131.69 / $151.72 / $270.70	Professional	26	$131.69	$151.72	$270.70
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $418.76 / $786.87 / $1,710.85	Professional	TC	$418.76	$786.87	$1,710.85
United Facility/Professional Professional Modifier Low / Median / High Price $357.65 / $624.98 / $1,485.76	Professional		$357.65	$624.98	$1,485.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.30 / $99.44 / $217.90	Professional	26	$54.30	$99.44	$217.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $300.01 / $538.46 / $1,267.85	Professional	TC	$300.01	$538.46	$1,267.85