Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.40 / $45.32 / $69.38	Facility	26	$39.40	$45.32	$69.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.29 / $131.24 / $232.80	Professional		$86.29	$131.24	$232.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.42 / $34.10 / $96.69	Professional	26	$23.42	$34.10	$96.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $62.86 / $99.75 / $181.74	Professional	TC	$62.86	$99.75	$181.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.00 / $54.00 / $626.35	Professional		$54.00	$54.00	$626.35
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.69 / $14.69 / $157.57	Professional	26	$14.69	$14.69	$157.57
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $39.31 / $39.31 / $468.78	Professional	TC	$39.31	$39.31	$468.78
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $88.31 / $103.20 / $166.45	Facility	26	$88.31	$103.20	$166.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.18 / $214.09 / $425.99	Professional		$60.18	$214.09	$425.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.55 / $53.39 / $106.53	Professional	26	$15.55	$53.39	$106.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $44.63 / $160.69 / $319.45	Professional	TC	$44.63	$160.69	$319.45
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $148.36 / $148.36 / $148.36	Facility	26	$148.36	$148.36	$148.36
Medica Facility/Professional Professional Modifier Low / Median / High Price $89.28 / $134.06 / $490.70	Professional		$89.28	$134.06	$490.70
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $25.21 / $35.74 / $133.03	Professional	26	$25.21	$35.74	$133.03
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $63.88 / $98.75 / $361.45	Professional	TC	$63.88	$98.75	$361.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $88.50 / $260.50	Professional		$50.00	$88.50	$260.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $186.18 / $305.27 / $425.70	Professional		$186.18	$305.27	$425.70
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $101.53 / $148.36 / $148.36	Facility	26	$101.53	$148.36	$148.36
Quartz Facility/Professional Professional Modifier Low / Median / High Price $64.00 / $512.04 / $875.57	Professional		$64.00	$512.04	$875.57
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $16.01 / $128.04 / $212.17	Professional	26	$16.01	$128.04	$212.17
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $48.00 / $384.00 / $663.40	Professional	TC	$48.00	$384.00	$663.40
Security Health Facility/Professional Professional Modifier Low / Median / High Price $95.90 / $95.90 / $687.52	Professional		$95.90	$95.90	$687.52
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.81 / $26.81 / $103.88	Professional	26	$26.81	$26.81	$103.88
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $69.08 / $69.08 / $267.70	Professional	TC	$69.08	$69.08	$267.70
United Facility/Professional Professional Modifier Low / Median / High Price $87.18 / $129.33 / $386.09	Professional		$87.18	$129.33	$386.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.41 / $35.31 / $101.69	Professional	26	$22.41	$35.31	$101.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $61.35 / $98.75 / $299.94	Professional	TC	$61.35	$98.75	$299.94