Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.46 / $60.48 / $117.15	Professional		$47.46	$60.48	$117.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $20.26 / $35.10	Professional	26	$18.62	$20.26	$35.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.21 / $41.55 / $82.05	Professional	TC	$27.21	$41.55	$82.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.93 / $173.64 / $382.86	Professional		$26.93	$173.64	$382.86
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.51 / $71.70 / $147.76	Professional	26	$10.51	$71.70	$147.76
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.42 / $107.65 / $230.64	Professional	TC	$16.42	$107.65	$230.64
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $76.87 / $87.35 / $123.99	Facility	26	$76.87	$87.35	$123.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.04 / $108.47 / $228.41	Professional		$39.04	$108.47	$228.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.28 / $33.14 / $79.06	Professional	26	$12.28	$33.14	$79.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.75 / $77.00 / $162.18	Professional	TC	$21.75	$77.00	$162.18
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $112.04 / $112.04 / $112.04	Facility	26	$112.04	$112.04	$112.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $48.15 / $86.00 / $466.08	Professional		$48.15	$86.00	$466.08
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $17.67 / $28.58 / $186.58	Professional	26	$17.67	$28.58	$186.58
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $26.89 / $46.32 / $309.75	Professional	TC	$26.89	$46.32	$309.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.35 / $65.00 / $148.36	Professional		$27.35	$65.00	$148.36
Quartz Facility/Professional Professional Modifier Low / Median / High Price $114.22 / $194.37 / $272.61	Professional		$114.22	$194.37	$272.61
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $112.04	Facility	26	$100.00	$100.00	$112.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $332.85 / $466.08	Professional		$38.90	$332.85	$466.08
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $12.99 / $128.50 / $186.58	Professional	26	$12.99	$128.50	$186.58
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $25.96 / $216.24 / $309.75	Professional	TC	$25.96	$216.24	$309.75
Security Health Facility/Professional Professional Modifier Low / Median / High Price $108.43 / $185.72 / $417.96	Professional		$108.43	$185.72	$417.96
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.25 / $19.25 / $91.70	Professional	26	$19.25	$19.25	$91.70
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.69 / $28.69 / $136.72	Professional	TC	$28.69	$28.69	$136.72
United Facility/Professional Professional Modifier Low / Median / High Price $45.26 / $66.56 / $207.01	Professional		$45.26	$66.56	$207.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.89 / $25.70 / $74.02	Professional	26	$18.89	$25.70	$74.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.59 / $40.86 / $117.70	Professional	TC	$27.59	$40.86	$117.70