Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.31 / $123.73 / $191.19	Professional		$84.31	$123.73	$191.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.48 / $81.12 / $337.25	Professional	26	$64.48	$81.12	$337.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.82 / $32.19 / $61.21	Professional	TC	$19.82	$32.19	$61.21
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.87 / $332.97 / $771.82	Professional		$54.87	$332.97	$771.82
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.58 / $248.14 / $513.08	Professional	26	$36.58	$248.14	$513.08
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.33 / $104.14 / $193.70	Professional	TC	$22.33	$104.14	$193.70
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $270.63 / $307.52 / $436.51	Facility	26	$270.63	$307.52	$436.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.58 / $161.68 / $372.38	Professional		$55.58	$161.68	$372.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.54 / $119.64 / $278.70	Professional	26	$42.54	$119.64	$278.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.83 / $42.04 / $93.64	Professional	TC	$13.83	$42.04	$93.64
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $390.55 / $390.55 / $390.55	Facility	26	$390.55	$390.55	$390.55
Medica Facility/Professional Professional Modifier Low / Median / High Price $81.13 / $157.79 / $745.14	Professional		$81.13	$157.79	$745.14
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $61.24 / $98.24 / $538.00	Professional	26	$61.24	$98.24	$538.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $20.09 / $52.23 / $340.13	Professional	TC	$20.09	$52.23	$340.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.01 / $65.00 / $299.62	Professional		$41.01	$65.00	$299.62
Quartz Facility/Professional Professional Modifier Low / Median / High Price $208.80 / $268.41 / $390.35	Professional		$208.80	$268.41	$390.35
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $167.50 / $167.50 / $390.55	Facility	26	$167.50	$167.50	$390.55
Quartz Facility/Professional Professional Modifier Low / Median / High Price $58.95 / $687.79 / $745.14	Professional		$58.95	$687.79	$745.14
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $44.64 / $446.10 / $538.00	Professional	26	$44.64	$446.10	$538.00
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $14.07 / $265.61 / $340.13	Professional	TC	$14.07	$265.61	$340.13
Security Health Facility/Professional Professional Modifier Low / Median / High Price $235.15 / $318.67 / $600.98	Professional		$235.15	$318.67	$600.98
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $66.73 / $66.73 / $318.08	Professional	26	$66.73	$66.73	$318.08
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $29.46 / $29.46 / $140.38	Professional	TC	$29.46	$29.46	$140.38
United Facility/Professional Professional Modifier Low / Median / High Price $79.41 / $114.34 / $350.08	Professional		$79.41	$114.34	$350.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $59.84 / $89.22 / $286.67	Professional	26	$59.84	$89.22	$286.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.09 / $28.34 / $97.12	Professional	TC	$20.09	$28.34	$97.12