Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.80 / $53.35 / $79.98	Professional		$49.80	$53.35	$79.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.12 / $19.07 / $29.38	Professional	26	$18.12	$19.07	$29.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $31.11 / $35.22 / $50.61	Professional	TC	$31.11	$35.22	$50.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.11 / $201.35 / $414.55	Professional		$32.11	$201.35	$414.55
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.52 / $75.19 / $156.49	Professional	26	$11.52	$75.19	$156.49
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.59 / $126.16 / $258.07	Professional	TC	$20.59	$126.16	$258.07
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $76.87 / $87.35 / $123.99	Facility	26	$76.87	$87.35	$123.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.79 / $89.33 / $217.28	Professional		$30.79	$89.33	$217.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.70 / $32.77 / $80.16	Professional	26	$11.70	$32.77	$80.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.09 / $58.21 / $137.10	Professional	TC	$19.09	$58.21	$137.10
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $110.49 / $110.49 / $110.49	Facility	26	$110.49	$110.49	$110.49
Medica Facility/Professional Professional Modifier Low / Median / High Price $52.85 / $72.08 / $438.19	Professional		$52.85	$72.08	$438.19
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $18.21 / $27.21 / $158.25	Professional	26	$18.21	$27.21	$158.25
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $34.36 / $44.87 / $279.94	Professional	TC	$34.36	$44.87	$279.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.09 / $65.00 / $162.88	Professional		$19.09	$65.00	$162.88
Quartz Facility/Professional Professional Modifier Low / Median / High Price $115.68 / $151.94 / $223.71	Professional		$115.68	$151.94	$223.71
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $54.72 / $54.72 / $110.49	Facility	26	$54.72	$54.72	$110.49
Quartz Facility/Professional Professional Modifier Low / Median / High Price $34.99 / $360.40 / $438.19	Professional		$34.99	$360.40	$438.19
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $12.80 / $136.05 / $158.25	Professional	26	$12.80	$136.05	$158.25
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $22.19 / $224.35 / $279.94	Professional	TC	$22.19	$224.35	$279.94
Security Health Facility/Professional Professional Modifier Low / Median / High Price $57.94 / $57.94 / $350.64	Professional		$57.94	$57.94	$350.64
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $21.14 / $21.14 / $81.97	Professional	26	$21.14	$21.14	$81.97
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $36.79 / $36.79 / $142.69	Professional	TC	$36.79	$36.79	$142.69
United Facility/Professional Professional Modifier Low / Median / High Price $46.62 / $72.08 / $207.59	Professional		$46.62	$72.08	$207.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.21 / $27.21 / $78.36	Professional	26	$18.21	$27.21	$78.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.19 / $44.87 / $145.83	Professional	TC	$32.19	$44.87	$145.83