Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.34 / $45.24 / $158.56	Facility	26	$39.34	$45.24	$158.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $127.21 / $161.69 / $350.00	Professional		$127.21	$161.69	$350.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.34 / $52.66 / $186.78	Professional	26	$39.34	$52.66	$186.78
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $604.69 / $604.69 / $604.69	Professional	50	$604.69	$604.69	$604.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.06 / $108.00 / $218.29	Professional	TC	$83.06	$108.00	$218.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $99.06 / $205.98 / $370.29	Professional		$99.06	$205.98	$370.29
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $40.97 / $70.69 / $132.62	Professional	26	$40.97	$70.69	$132.62
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $143.16 / $319.60 / $609.78	Professional	50	$143.16	$319.60	$609.78
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $51.35 / $136.29 / $253.28	Professional	TC	$51.35	$136.29	$253.28
CareSource Facility/Professional Professional Modifier Low / Median / High Price $44.88 / $127.99 / $190.80	Professional		$44.88	$127.99	$190.80
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $111.74 / $130.58 / $173.55	Facility	26	$111.74	$130.58	$173.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $140.10 / $326.89 / $392.10	Professional		$140.10	$326.89	$392.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.22 / $84.70 / $103.66	Professional	26	$47.22	$84.70	$103.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $92.88 / $242.19 / $275.32	Professional	TC	$92.88	$242.19	$275.32
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $214.20 / $214.20 / $214.20	Facility	26	$214.20	$214.20	$214.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $117.70 / $200.00 / $834.21	Professional		$117.70	$200.00	$834.21
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $44.81 / $84.51 / $261.89	Professional	26	$44.81	$84.51	$261.89
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $66.95 / $122.50 / $595.82	Professional	TC	$66.95	$122.50	$595.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.31 / $131.42 / $307.93	Professional		$55.31	$131.42	$307.93
Quartz Facility/Professional Professional Modifier Low / Median / High Price $228.40 / $364.05 / $519.20	Professional		$228.40	$364.05	$519.20
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.93 / $214.20 / $214.20	Facility	26	$100.93	$214.20	$214.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $253.86 / $701.10 / $834.21	Professional		$253.86	$701.10	$834.21
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $78.48 / $214.70 / $261.89	Professional	26	$78.48	$214.70	$261.89
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $175.36 / $519.44 / $595.82	Professional	TC	$175.36	$519.44	$595.82
Security Health Facility/Professional Professional Modifier Low / Median / High Price $130.94 / $573.77 / $573.77	Professional		$130.94	$573.77	$573.77
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $57.31 / $67.42 / $128.41	Professional	26	$57.31	$67.42	$128.41
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $63.43 / $78.01 / $188.93	Professional	TC	$63.43	$78.01	$188.93
United Facility/Professional Professional Modifier Low / Median / High Price $117.70 / $179.06 / $354.48	Professional		$117.70	$179.06	$354.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.03 / $77.23 / $127.53	Professional	26	$44.03	$77.23	$127.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.95 / $107.93 / $268.31	Professional	TC	$66.95	$107.93	$268.31