Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.96 / $131.93 / $258.08	Professional		$81.96	$131.93	$258.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.62 / $38.70 / $54.07	Professional	26	$24.62	$38.70	$54.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $57.34 / $93.23 / $204.02	Professional	TC	$57.34	$93.23	$204.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $105.65 / $377.85 / $670.87	Professional		$105.65	$377.85	$670.87
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.10 / $113.66 / $201.40	Professional	26	$24.10	$113.66	$201.40
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $81.56 / $254.03 / $476.27	Professional	TC	$81.56	$254.03	$476.27
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $101.09 / $114.88 / $163.06	Facility	26	$101.09	$114.88	$163.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.82 / $176.14 / $357.24	Professional		$50.82	$176.14	$357.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.86 / $52.37 / $104.56	Professional	26	$15.86	$52.37	$104.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.54 / $128.02 / $252.68	Professional	TC	$35.54	$128.02	$252.68
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $256.47 / $256.47 / $256.47	Facility	26	$256.47	$256.47	$256.47
Medica Facility/Professional Professional Modifier Low / Median / High Price $88.12 / $210.68 / $1,210.67	Professional		$88.12	$210.68	$1,210.67
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $25.42 / $58.81 / $360.79	Professional	26	$25.42	$58.81	$360.79
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $60.10 / $160.78 / $914.18	Professional	TC	$60.10	$160.78	$914.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $35.54 / $65.00 / $272.69	Professional		$35.54	$65.00	$272.69
Quartz Facility/Professional Professional Modifier Low / Median / High Price $196.20 / $257.94 / $366.80	Professional		$196.20	$257.94	$366.80
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $69.17 / $69.17 / $256.47	Facility	26	$69.17	$69.17	$256.47
Quartz Facility/Professional Professional Modifier Low / Median / High Price $59.84 / $1,144.30 / $1,210.67	Professional		$59.84	$1,144.30	$1,210.67
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $17.23 / $301.64 / $360.79	Professional	26	$17.23	$301.64	$360.79
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $42.60 / $842.66 / $914.18	Professional	TC	$42.60	$842.66	$914.18
Security Health Facility/Professional Professional Modifier Low / Median / High Price $300.45 / $303.85 / $576.52	Professional		$300.45	$303.85	$576.52
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.72 / $26.72 / $127.34	Professional	26	$26.72	$26.72	$127.34
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $50.81 / $50.81 / $242.18	Professional	TC	$50.81	$50.81	$242.18
United Facility/Professional Professional Modifier Low / Median / High Price $74.54 / $110.15 / $391.85	Professional		$74.54	$110.15	$391.85
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.42 / $35.02 / $128.18	Professional	26	$25.42	$35.02	$128.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $60.10 / $75.13 / $275.00	Professional	TC	$60.10	$75.13	$275.00