Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.58 / $60.58 / $116.21	Facility	26	$60.58	$60.58	$116.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.32 / $78.61 / $148.35	Professional		$56.32	$78.61	$148.35
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.65 / $41.14 / $117.07	Professional	26	$30.65	$41.14	$117.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.19 / $43.08 / $71.04	Professional	TC	$20.19	$43.08	$71.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.15 / $108.97 / $404.78	Professional		$54.15	$108.97	$404.78
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.92 / $56.77 / $187.91	Professional	26	$31.92	$56.77	$187.91
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.85 / $52.57 / $166.82	Professional	TC	$21.85	$52.57	$166.82
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $82.00 / $95.83 / $147.00	Facility	26	$82.00	$95.83	$147.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.62 / $194.19 / $220.68	Professional		$101.62	$194.19	$220.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.30 / $89.03 / $101.64	Professional	26	$48.30	$89.03	$101.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $53.33 / $105.13 / $119.46	Professional	TC	$53.33	$105.13	$119.46
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $72.78 / $145.80 / $145.80	Facility	26	$72.78	$145.80	$145.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $61.90 / $98.06 / $486.90	Professional		$61.90	$98.06	$486.90
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $34.86 / $60.13 / $196.52	Professional	26	$34.86	$60.13	$196.52
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.18 / $41.62 / $244.63	Professional	TC	$23.18	$41.62	$244.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.04 / $55.81 / $125.50	Professional		$25.04	$55.81	$125.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $106.10 / $156.97 / $215.28	Professional		$106.10	$156.97	$215.28
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $41.44 / $72.78 / $145.80	Facility	26	$41.44	$72.78	$145.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $112.59 / $297.14 / $486.90	Professional		$112.59	$297.14	$486.90
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $51.63 / $161.25 / $196.52	Professional	26	$51.63	$161.25	$196.52
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $56.43 / $156.74 / $244.63	Professional	TC	$56.43	$156.74	$244.63
Security Health Facility/Professional Professional Modifier Low / Median / High Price $93.80 / $313.18 / $460.09	Professional		$93.80	$313.18	$460.09
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $114.07 / $134.19 / $167.41	Professional	26	$114.07	$134.19	$167.41
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $60.08 / $70.68 / $169.96	Professional	TC	$60.08	$70.68	$169.96
United Facility/Professional Professional Modifier Low / Median / High Price $61.90 / $98.06 / $198.68	Professional		$61.90	$98.06	$198.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.20 / $56.26 / $112.88	Professional	26	$33.20	$56.26	$112.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.72 / $44.85 / $90.87	Professional	TC	$24.72	$44.85	$90.87