Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.17 / $16.17 / $16.17	Facility	26	$16.17	$16.17	$16.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $98.04 / $130.35 / $317.25	Professional		$98.04	$130.35	$317.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.51 / $16.09 / $44.19	Professional	26	$13.51	$16.09	$44.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.45 / $114.89 / $295.70	Professional	TC	$79.45	$114.89	$295.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.52 / $244.41 / $487.42	Professional		$100.52	$244.41	$487.42
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.91 / $31.19 / $65.79	Professional	26	$14.91	$31.19	$65.79
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $87.00 / $214.83 / $429.66	Professional	TC	$87.00	$214.83	$429.66
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.75 / $45.28 / $51.45	Facility	26	$38.75	$45.28	$51.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $140.47 / $285.32 / $382.49	Professional		$140.47	$285.32	$382.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.20 / $33.19 / $42.98	Professional	26	$16.20	$33.19	$42.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $122.87 / $254.88 / $339.49	Professional	TC	$122.87	$254.88	$339.49
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $34.29 / $100.00 / $100.00	Facility	26	$34.29	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $92.74 / $149.57 / $447.33	Professional		$92.74	$149.57	$447.33
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.82 / $21.25 / $70.26	Professional	26	$13.82	$21.25	$70.26
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $79.78 / $128.13 / $377.07	Professional	TC	$79.78	$128.13	$377.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $76.01 / $151.64 / $284.79	Professional		$76.01	$151.64	$284.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $112.00 / $302.02 / $428.39	Professional		$112.00	$302.02	$428.39
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $29.99 / $34.29 / $100.00	Facility	26	$29.99	$34.29	$100.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $165.82 / $569.61 / $800.25	Professional		$165.82	$569.61	$800.25
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $18.63 / $75.15 / $135.38	Professional	26	$18.63	$75.15	$135.38
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $147.18 / $505.58 / $706.26	Professional	TC	$147.18	$505.58	$706.26
Security Health Facility/Professional Professional Modifier Low / Median / High Price $213.83 / $679.82 / $679.82	Professional		$213.83	$679.82	$679.82
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.73 / $33.45 / $44.36	Professional	26	$18.73	$33.45	$44.36
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $134.93 / $192.96 / $284.25	Professional	TC	$134.93	$192.96	$284.25
United Facility/Professional Professional Modifier Low / Median / High Price $91.29 / $154.10 / $354.13	Professional		$91.29	$154.10	$354.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.82 / $20.46 / $49.40	Professional	26	$13.82	$20.46	$49.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $78.11 / $129.41 / $304.73	Professional	TC	$78.11	$129.41	$304.73