Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.91 / $19.91 / $79.64	Facility	26	$19.91	$19.91	$79.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.95 / $47.50 / $179.95	Professional		$33.95	$47.50	$179.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.73 / $23.39 / $65.84	Professional	26	$18.73	$23.39	$65.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.66 / $19.87 / $106.51	Professional	TC	$15.66	$19.87	$106.51
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.11 / $75.18 / $122.97	Professional		$38.11	$75.18	$122.97
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $21.86 / $36.17 / $68.64	Professional	26	$21.86	$36.17	$68.64
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $57.18 / $103.71 / $184.45	Professional	50	$57.18	$103.71	$184.45
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.99 / $33.69 / $60.05	Professional	TC	$15.99	$33.69	$60.05
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.77 / $66.34 / $88.17	Facility	26	$56.77	$66.34	$88.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.49 / $78.86 / $146.08	Professional		$53.49	$78.86	$146.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.68 / $42.87 / $55.04	Professional	26	$28.68	$42.87	$55.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.04 / $35.65 / $76.25	Professional	TC	$23.04	$35.65	$76.25
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $201.45 / $201.45 / $201.45	Facility	26	$201.45	$201.45	$201.45
Medica Facility/Professional Professional Modifier Low / Median / High Price $44.40 / $99.03 / $764.92	Professional		$44.40	$99.03	$764.92
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $26.15 / $49.82 / $382.94	Professional	26	$26.15	$49.82	$382.94
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $18.25 / $41.68 / $585.86	Professional	TC	$18.25	$41.68	$585.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.71 / $48.79 / $77.04	Professional		$19.71	$48.79	$77.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $72.40 / $104.31 / $471.79	Professional		$72.40	$104.31	$471.79
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $201.45 / $201.45	Facility	26	$100.00	$201.45	$201.45
Quartz Facility/Professional Professional Modifier Low / Median / High Price $74.84 / $430.12 / $764.92	Professional		$74.84	$430.12	$764.92
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $40.20 / $136.26 / $382.94	Professional	26	$40.20	$136.26	$382.94
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $32.28 / $316.57 / $585.86	Professional	TC	$32.28	$316.57	$585.86
Security Health Facility/Professional Professional Modifier Low / Median / High Price $58.78 / $137.85 / $137.85	Professional		$58.78	$137.85	$137.85
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $29.27 / $34.43 / $63.34	Professional	26	$29.27	$34.43	$63.34
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.70 / $24.37 / $46.37	Professional	TC	$20.70	$24.37	$46.37
United Facility/Professional Professional Modifier Low / Median / High Price $39.70 / $75.92 / $177.63	Professional		$39.70	$75.92	$177.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.74 / $43.13 / $76.20	Professional	26	$22.74	$43.13	$76.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.25 / $35.22 / $125.69	Professional	TC	$18.25	$35.22	$125.69