Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.25 / $53.54 / $94.11	Professional		$41.25	$53.54	$94.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.47 / $34.72 / $123.20	Professional	26	$27.47	$34.72	$123.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $13.77 / $19.60 / $36.54	Professional	TC	$13.77	$19.60	$36.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.10 / $164.11 / $338.65	Professional		$24.10	$164.11	$338.65
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.27 / $109.25 / $223.07	Professional	26	$16.27	$109.25	$223.07
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $9.40 / $57.58 / $112.70	Professional	TC	$9.40	$57.58	$112.70
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $113.73 / $129.24 / $183.44	Facility	26	$113.73	$129.24	$183.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.58 / $75.41 / $178.76	Professional		$27.58	$75.41	$178.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.01 / $50.35 / $117.28	Professional	26	$18.01	$50.35	$117.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $9.03 / $27.25 / $57.69	Professional	TC	$9.03	$27.25	$57.69
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $165.02 / $165.02 / $165.02	Facility	26	$165.02	$165.02	$165.02
Medica Facility/Professional Professional Modifier Low / Median / High Price $39.59 / $64.73 / $353.10	Professional		$39.59	$64.73	$353.10
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $26.86 / $43.24 / $231.59	Professional	26	$26.86	$43.24	$231.59
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $13.21 / $23.64 / $121.51	Professional	TC	$13.21	$23.64	$121.51
Molina Facility/Professional Professional Modifier Low / Median / High Price $17.28 / $63.16 / $128.38	Professional		$17.28	$63.16	$128.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $27.72 / $128.81 / $187.32	Professional		$27.72	$128.81	$187.32
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $70.48 / $70.48 / $165.02	Facility	26	$70.48	$70.48	$165.02
Quartz Facility/Professional Professional Modifier Low / Median / High Price $27.58 / $279.60 / $353.10	Professional		$27.58	$279.60	$353.10
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $18.54 / $193.95 / $231.59	Professional	26	$18.54	$193.95	$231.59
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $9.24 / $91.97 / $121.51	Professional	TC	$9.24	$91.97	$121.51
Security Health Facility/Professional Professional Modifier Low / Median / High Price $168.25 / $169.30 / $288.51	Professional		$168.25	$169.30	$288.51
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $29.67 / $29.67 / $141.41	Professional	26	$29.67	$29.67	$141.41
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $14.02 / $14.02 / $66.81	Professional	TC	$14.02	$14.02	$66.81
United Facility/Professional Professional Modifier Low / Median / High Price $39.59 / $55.92 / $198.30	Professional		$39.59	$55.92	$198.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.38 / $38.79 / $126.07	Professional	26	$26.38	$38.79	$126.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $13.21 / $17.13 / $49.55	Professional	TC	$13.21	$17.13	$49.55