Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $141.53 / $141.53 / $194.94	Facility	26	$141.53	$141.53	$194.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $152.31 / $220.70 / $306.16	Professional		$152.31	$220.70	$306.16
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.42 / $76.20 / $111.22	Professional	TC	$56.42	$76.20	$111.22
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $142.38 / $291.20 / $904.24	Professional		$142.38	$291.20	$904.24
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $48.07 / $103.40 / $299.54	Professional	TC	$48.07	$103.40	$299.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $245.10 / $286.42 / $439.38	Facility	26	$245.10	$286.42	$439.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $210.91 / $514.55 / $584.73	Professional		$210.91	$514.55	$584.73
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $76.62 / $187.21 / $212.74	Professional	TC	$76.62	$187.21	$212.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $164.80 / $386.25 / $1,161.00	Professional		$164.80	$386.25	$1,161.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $53.81 / $132.44 / $585.04	Professional	TC	$53.81	$132.44	$585.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $56.25 / $117.87 / $247.51	Professional		$56.25	$117.87	$247.51
Quartz Facility/Professional Professional Modifier Low / Median / High Price $216.61 / $343.92 / $622.20	Professional		$216.61	$343.92	$622.20
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $425.13 / $425.13 / $425.13	Facility	26	$425.13	$425.13	$425.13
Quartz Facility/Professional Professional Modifier Low / Median / High Price $244.69 / $731.10 / $1,161.00	Professional		$244.69	$731.10	$1,161.00
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $78.84 / $314.30 / $585.04	Professional	TC	$78.84	$314.30	$585.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $485.64 / $898.30 / $898.30	Professional		$485.64	$898.30	$898.30
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $143.26 / $169.30 / $282.87	Professional	TC	$143.26	$169.30	$282.87
United Facility/Professional Professional Modifier Low / Median / High Price $164.80 / $357.07 / $790.51	Professional		$164.80	$357.07	$790.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $53.81 / $119.34 / $235.00	Professional	TC	$53.81	$119.34	$235.00