Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.59 / $68.59 / $95.27	Facility	26	$68.59	$68.59	$95.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $223.98 / $317.76 / $1,312.00	Professional		$223.98	$317.76	$1,312.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.77 / $68.59 / $244.00	Professional	26	$42.77	$68.59	$244.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $177.58 / $227.42 / $303.39	Professional	TC	$177.58	$227.42	$303.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $205.00 / $336.03 / $1,159.58	Professional		$205.00	$336.03	$1,159.58
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $44.26 / $70.55 / $249.04	Professional	26	$44.26	$70.55	$249.04
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $160.75 / $265.48 / $910.54	Professional	TC	$160.75	$265.48	$910.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $119.85 / $136.19 / $214.84	Facility	26	$119.85	$136.19	$214.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $296.61 / $738.79 / $839.54	Professional		$296.61	$738.79	$839.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.63 / $160.38 / $182.25	Professional	26	$65.63	$160.38	$182.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $236.66 / $578.41 / $657.29	Professional	TC	$236.66	$578.41	$657.29
Medica Facility/Professional Professional Modifier Low / Median / High Price $247.24 / $509.09 / $1,481.01	Professional		$247.24	$509.09	$1,481.01
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $52.02 / $108.67 / $501.94	Professional	26	$52.02	$108.67	$501.94
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $191.67 / $403.33 / $1,231.75	Professional	TC	$191.67	$403.33	$1,231.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $159.05 / $377.33	Professional		$65.00	$159.05	$377.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $402.35 / $602.78 / $893.34	Professional		$402.35	$602.78	$893.34
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $210.21 / $210.21 / $210.21	Facility	26	$210.21	$210.21	$210.21
Quartz Facility/Professional Professional Modifier Low / Median / High Price $311.16 / $1,114.75 / $1,481.01	Professional		$311.16	$1,114.75	$1,481.01
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $67.54 / $237.95 / $501.94	Professional	26	$67.54	$237.95	$501.94
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $243.62 / $876.80 / $1,231.75	Professional	TC	$243.62	$876.80	$1,231.75
Security Health Facility/Professional Professional Modifier Low / Median / High Price $606.62 / $1,316.41 / $1,316.41	Professional		$606.62	$1,316.41	$1,316.41
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $126.08 / $159.53 / $259.92	Professional	26	$126.08	$159.53	$259.92
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $480.55 / $482.49 / $1,058.98	Professional	TC	$480.55	$482.49	$1,058.98
United Facility/Professional Professional Modifier Low / Median / High Price $236.49 / $467.18 / $977.08	Professional		$236.49	$467.18	$977.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.99 / $96.10 / $208.56	Professional	26	$51.99	$96.10	$208.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $191.67 / $400.42 / $768.52	Professional	TC	$191.67	$400.42	$768.52