Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.49 / $75.38 / $104.67	Facility	26	$53.49	$75.38	$104.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $318.73 / $398.56 / $1,975.00	Professional		$318.73	$398.56	$1,975.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.85 / $75.38 / $296.95	Professional	26	$45.85	$75.38	$296.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $272.87 / $334.82 / $544.17	Professional	TC	$272.87	$334.82	$544.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $338.05 / $530.62 / $1,942.70	Professional		$338.05	$530.62	$1,942.70
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $48.63 / $76.41 / $271.95	Professional	26	$48.63	$76.41	$271.95
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $286.42 / $455.24 / $1,672.77	Professional	TC	$286.42	$455.24	$1,672.77
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $131.56 / $149.50 / $235.84	Facility	26	$131.56	$149.50	$235.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $486.37 / $1,219.68 / $1,386.00	Professional		$486.37	$1,219.68	$1,386.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.11 / $175.43 / $199.35	Professional	26	$72.11	$175.43	$199.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $414.26 / $1,044.24 / $1,186.64	Professional	TC	$414.26	$1,044.24	$1,186.64
Medica Facility/Professional Professional Modifier Low / Median / High Price $401.32 / $761.18 / $2,348.14	Professional		$401.32	$761.18	$2,348.14
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $56.74 / $118.53 / $379.76	Professional	26	$56.74	$118.53	$379.76
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $345.59 / $706.98 / $2,034.68	Professional	TC	$345.59	$706.98	$2,034.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.14 / $275.10 / $626.08	Professional		$65.14	$275.10	$626.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $659.10 / $972.54 / $1,474.82	Professional		$659.10	$972.54	$1,474.82
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $236.00 / $236.00 / $236.00	Facility	26	$236.00	$236.00	$236.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $513.70 / $1,902.95 / $2,348.14	Professional		$513.70	$1,902.95	$2,348.14
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $73.88 / $259.55 / $379.76	Professional	26	$73.88	$259.55	$379.76
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $439.82 / $1,643.45 / $2,034.68	Professional	TC	$439.82	$1,643.45	$2,034.68
Security Health Facility/Professional Professional Modifier Low / Median / High Price $830.29 / $2,173.31 / $2,173.31	Professional		$830.29	$2,173.31	$2,173.31
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $136.52 / $172.74 / $280.63	Professional	26	$136.52	$172.74	$280.63
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $654.95 / $770.53 / $1,656.37	Professional	TC	$654.95	$770.53	$1,656.37
United Facility/Professional Professional Modifier Low / Median / High Price $401.32 / $761.18 / $2,021.08	Professional		$401.32	$761.18	$2,021.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.65 / $103.87 / $254.02	Professional	26	$57.65	$103.87	$254.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $345.78 / $657.36 / $1,415.34	Professional	TC	$345.78	$657.36	$1,415.34