Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $295.12 / $467.74	Professional		$204.17	$295.12	$467.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $43.65 / $190.55	Professional	26	$33.88	$43.65	$190.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $251.19 / $407.38	Professional	TC	$165.96	$251.19	$407.38
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $616.60 / $1,995.26	Professional		$141.25	$616.60	$1,995.26
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $125.89 / $275.42	Professional	26	$18.62	$125.89	$275.42
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $575.44 / $1,698.24	Professional	TC	$123.03	$575.44	$1,698.24
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $128.82 / $144.54 / $213.80	Facility	26	$128.82	$144.54	$213.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $363.08 / $912.01	Professional		$125.89	$363.08	$912.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $53.70 / $128.82	Professional	26	$19.95	$53.70	$128.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $309.03 / $776.25	Professional	TC	$107.15	$309.03	$776.25
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $741.31 / $812.83	Professional		$741.31	$741.31	$812.83
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $112.20 / $123.03	Professional	26	$112.20	$112.20	$123.03
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $630.96 / $630.96 / $691.83	Professional	TC	$630.96	$630.96	$691.83
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $181.97 / $181.97 / $181.97	Facility	26	$181.97	$181.97	$181.97
Medica Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $331.13 / $2,089.30	Professional		$181.97	$331.13	$2,089.30
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $45.71 / $269.15	Professional	26	$30.90	$45.71	$269.15
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $288.40 / $1,819.70	Professional	TC	$141.25	$288.40	$1,819.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $58.88 / $85.11	Professional		$32.36	$58.88	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $630.96 / $912.01	Professional		$389.05	$630.96	$912.01
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $77.62 / $77.62 / $269.15	Facility	26	$77.62	$77.62	$269.15
Quartz Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $1,096.48 / $2,089.30	Professional		$125.89	$1,096.48	$2,089.30
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $151.36 / $269.15	Professional	26	$19.05	$151.36	$269.15
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $954.99 / $1,819.70	Professional	TC	$107.15	$954.99	$1,819.70
Security Health Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $954.99 / $1,862.09	Professional		$245.47	$954.99	$1,862.09
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $33.88 / $131.83	Professional	26	$33.88	$33.88	$131.83
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $213.80 / $851.14	Professional	TC	$213.80	$213.80	$851.14
United Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $323.59 / $707.95	Professional		$181.97	$323.59	$707.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $45.71 / $125.89	Professional	26	$27.54	$45.71	$125.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $275.42 / $616.60	Professional	TC	$141.25	$275.42	$616.60