Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.57 / $64.57 / $91.20	Facility	26	$64.57	$64.57	$91.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $213.80 / $309.03	Professional		$169.82	$213.80	$309.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $169.82 / $245.47	Professional	TC	$131.83	$169.82	$245.47
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $309.03 / $1,122.02	Professional		$199.53	$309.03	$1,122.02
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $245.47 / $891.25	Professional	TC	$158.49	$245.47	$891.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $112.20 / $131.83 / $208.93	Facility	26	$112.20	$131.83	$208.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $741.31 / $831.76	Professional		$316.23	$741.31	$831.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $588.84 / $660.69	Professional	TC	$251.19	$588.84	$660.69
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $478.63 / $602.56	Professional		$407.38	$478.63	$602.56
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $371.54 / $489.78	Professional	TC	$323.59	$371.54	$489.78
Medica Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $478.63 / $1,380.38	Professional		$239.88	$478.63	$1,380.38
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $398.11 / $1,174.90	Professional	TC	$190.55	$398.11	$1,174.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $331.13	Professional		$32.36	$33.11	$331.13
Quartz Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $588.84 / $912.01	Professional		$331.13	$588.84	$912.01
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $275.42 / $275.42	Facility	26	$100.00	$275.42	$275.42
Quartz Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $1,096.48 / $1,445.44	Professional		$295.12	$1,096.48	$1,445.44
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $870.96 / $1,202.26	Professional	TC	$229.09	$870.96	$1,202.26
Security Health Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $1,288.25 / $1,621.81	Professional		$537.03	$1,288.25	$1,621.81
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $407.38 / $489.78 / $1,047.13	Professional	TC	$407.38	$489.78	$1,047.13
United Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $426.58 / $954.99	Professional		$229.09	$426.58	$954.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $346.74 / $776.25	Professional	TC	$186.21	$346.74	$776.25