Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.38 / $136.43 / $267.56	Professional		$102.38	$136.43	$267.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.68 / $48.27 / $64.43	Professional	26	$30.68	$48.27	$64.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $71.70 / $97.91 / $203.38	Professional	TC	$71.70	$97.91	$203.38
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $88.50 / $393.50 / $688.95	Professional		$88.50	$393.50	$688.95
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.51 / $123.69 / $244.35	Professional	26	$24.51	$123.69	$244.35
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $63.99 / $272.49 / $473.52	Professional	TC	$63.99	$272.49	$473.52
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $128.47 / $145.99 / $207.22	Facility	26	$128.47	$145.99	$207.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.48 / $203.79 / $425.01	Professional		$69.48	$203.79	$425.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.96 / $64.15 / $132.85	Professional	26	$19.96	$64.15	$132.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.95 / $152.90 / $306.48	Professional	TC	$49.95	$152.90	$306.48
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $271.50 / $271.50 / $271.50	Facility	26	$271.50	$271.50	$271.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $101.48 / $207.72 / $1,070.24	Professional		$101.48	$207.72	$1,070.24
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $30.84 / $62.11 / $390.67	Professional	26	$30.84	$62.11	$390.67
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $66.38 / $136.82 / $793.60	Professional	TC	$66.38	$136.82	$793.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $49.95 / $70.00 / $313.08	Professional		$49.95	$70.00	$313.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $232.30 / $344.77 / $483.56	Professional		$232.30	$344.77	$483.56
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $84.89 / $84.89 / $271.50	Facility	26	$84.89	$84.89	$271.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $71.91 / $1,005.71 / $1,070.24	Professional		$71.91	$1,005.71	$1,070.24
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $21.16 / $315.66 / $390.67	Professional	26	$21.16	$315.66	$390.67
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $51.08 / $690.07 / $793.60	Professional	TC	$51.08	$690.07	$793.60
Security Health Facility/Professional Professional Modifier Low / Median / High Price $85.69 / $332.04 / $763.09	Professional		$85.69	$332.04	$763.09
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $31.28 / $31.28 / $149.04	Professional	26	$31.28	$31.28	$149.04
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $54.42 / $54.42 / $366.15	Professional	TC	$54.42	$54.42	$366.15
United Facility/Professional Professional Modifier Low / Median / High Price $101.48 / $128.00 / $415.58	Professional		$101.48	$128.00	$415.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.29 / $42.49 / $146.29	Professional	26	$29.29	$42.49	$146.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.38 / $85.51 / $274.32	Professional	TC	$66.38	$85.51	$274.32