Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.83 / $117.29 / $235.96	Professional		$87.83	$117.29	$235.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.32 / $30.52 / $51.69	Professional	26	$24.32	$30.52	$51.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.51 / $86.77 / $184.26	Professional	TC	$63.51	$86.77	$184.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.64 / $287.31 / $629.30	Professional		$44.64	$287.31	$629.30
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.54 / $92.30 / $191.24	Professional	26	$13.54	$92.30	$191.24
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $31.10 / $200.98 / $431.33	Professional	TC	$31.10	$200.98	$431.33
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $102.14 / $116.07 / $164.75	Facility	26	$102.14	$116.07	$164.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.94 / $162.50 / $370.08	Professional		$60.94	$162.50	$370.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.71 / $44.44 / $105.46	Professional	26	$15.71	$44.44	$105.46
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $44.42 / $131.32 / $274.62	Professional	TC	$44.42	$131.32	$274.62
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $149.85 / $149.85 / $149.85	Facility	26	$149.85	$149.85	$149.85
Medica Facility/Professional Professional Modifier Low / Median / High Price $66.30 / $111.46 / $730.19	Professional		$66.30	$111.46	$730.19
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $22.26 / $33.26 / $200.25	Professional	26	$22.26	$33.26	$200.25
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $42.99 / $78.20 / $531.07	Professional	TC	$42.99	$78.20	$531.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.25 / $65.00 / $255.30	Professional		$45.25	$65.00	$255.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $141.01 / $302.35 / $424.07	Professional		$141.01	$302.35	$424.07
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $63.38 / $63.38 / $149.85	Facility	26	$63.38	$63.38	$149.85
Quartz Facility/Professional Professional Modifier Low / Median / High Price $61.62 / $557.29 / $730.19	Professional		$61.62	$557.29	$730.19
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $15.88 / $166.30 / $200.25	Professional	26	$15.88	$166.30	$200.25
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $45.77 / $391.00 / $531.07	Professional	TC	$45.77	$391.00	$531.07
Security Health Facility/Professional Professional Modifier Low / Median / High Price $78.27 / $78.27 / $661.86	Professional		$78.27	$78.27	$661.86
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $24.62 / $24.62 / $95.49	Professional	26	$24.62	$24.62	$95.49
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $53.65 / $53.65 / $255.67	Professional	TC	$53.65	$53.65	$255.67
United Facility/Professional Professional Modifier Low / Median / High Price $66.26 / $111.46 / $321.00	Professional		$66.26	$111.46	$321.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.26 / $33.26 / $95.79	Professional	26	$22.26	$33.26	$95.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $43.32 / $78.20 / $225.21	Professional	TC	$43.32	$78.20	$225.21