Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $145.94 / $145.94 / $202.19	Facility	26	$145.94	$145.94	$202.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $895.02 / $1,263.32 / $3,721.00	Professional		$895.02	$1,263.32	$3,721.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.86 / $145.94 / $578.66	Professional	26	$95.86	$145.94	$578.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $796.42 / $1,117.39 / $1,958.70	Professional	TC	$796.42	$1,117.39	$1,958.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $815.05 / $1,342.37 / $5,360.84	Professional		$815.05	$1,342.37	$5,360.84
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $94.15 / $149.76 / $605.47	Professional	26	$94.15	$149.76	$605.47
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $720.90 / $1,192.60 / $4,755.37	Professional	TC	$720.90	$1,192.60	$4,755.37
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $252.31 / $286.72 / $452.31	Facility	26	$252.31	$286.72	$452.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,151.28 / $2,886.86 / $3,280.53	Professional		$1,151.28	$2,886.86	$3,280.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $139.29 / $337.22 / $383.20	Professional	26	$139.29	$337.22	$383.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $1,012.00 / $2,549.66 / $2,897.34	Professional	TC	$1,012.00	$2,549.66	$2,897.34
Medica Facility/Professional Professional Modifier Low / Median / High Price $970.54 / $1,847.38 / $5,628.92	Professional		$970.54	$1,847.38	$5,628.92
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $110.60 / $212.00 / $611.21	Professional	26	$110.60	$212.00	$611.21
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $859.76 / $1,635.38 / $5,017.71	Professional	TC	$859.76	$1,635.38	$5,017.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $80.47 / $525.99 / $1,491.43	Professional		$80.47	$525.99	$1,491.43
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,499.71 / $1,895.49 / $2,643.30	Professional		$1,499.71	$1,895.49	$2,643.30
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $432.95 / $432.95 / $432.95	Facility	26	$432.95	$432.95	$432.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,215.88 / $4,533.70 / $5,628.92	Professional		$1,215.88	$4,533.70	$5,628.92
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $142.03 / $505.95 / $611.21	Professional	26	$142.03	$505.95	$611.21
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $1,073.84 / $4,027.80 / $5,017.71	Professional	TC	$1,073.84	$4,027.80	$5,017.71
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,157.10 / $5,144.06 / $5,144.06	Professional		$2,157.10	$5,144.06	$5,144.06
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $225.81 / $265.66 / $460.42	Professional	26	$225.81	$265.66	$460.42
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,811.45 / $2,131.12 / $3,784.80	Professional	TC	$1,811.45	$2,131.12	$3,784.80
United Facility/Professional Professional Modifier Low / Median / High Price $957.83 / $1,813.48 / $3,973.79	Professional		$957.83	$1,813.48	$3,973.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $110.52 / $212.00 / $443.47	Professional	26	$110.52	$212.00	$443.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $847.31 / $1,635.37 / $3,530.32	Professional	TC	$847.31	$1,635.37	$3,530.32