Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $71.93 / $71.93 / $136.74	Facility	26	$71.93	$71.93	$136.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.09 / $102.55 / $328.91	Professional		$71.09	$102.55	$328.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.36 / $52.67 / $211.00	Professional	26	$35.36	$52.67	$211.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.57 / $48.74 / $82.63	Professional	TC	$23.57	$48.74	$82.63
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.43 / $128.30 / $477.87	Professional		$63.43	$128.30	$477.87
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.90 / $67.20 / $224.38	Professional	26	$37.90	$67.20	$224.38
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.30 / $61.14 / $192.33	Professional	TC	$25.30	$61.14	$192.33
CareSource Facility/Professional Professional Modifier Low / Median / High Price $37.26 / $77.78 / $159.01	Professional		$37.26	$77.78	$159.01
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.32 / $113.73 / $174.46	Facility	26	$97.32	$113.73	$174.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $118.90 / $227.39 / $258.39	Professional		$118.90	$227.39	$258.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.85 / $105.91 / $120.35	Professional	26	$56.85	$105.91	$120.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.86 / $121.48 / $138.05	Professional	TC	$61.86	$121.48	$138.05
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $85.71 / $174.72 / $174.72	Facility	26	$85.71	$174.72	$174.72
Medica Facility/Professional Professional Modifier Low / Median / High Price $72.28 / $115.57 / $568.04	Professional		$72.28	$115.57	$568.04
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $41.28 / $72.13 / $236.22	Professional	26	$41.28	$72.13	$236.22
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $26.58 / $48.43 / $285.88	Professional	TC	$26.58	$48.43	$285.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.07 / $62.01 / $182.82	Professional		$25.07	$62.01	$182.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $125.26 / $183.00 / $250.98	Professional		$125.26	$183.00	$250.98
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $48.76 / $85.71 / $174.72	Facility	26	$48.76	$85.71	$174.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $131.84 / $350.20 / $568.04	Professional		$131.84	$350.20	$568.04
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $61.41 / $192.05 / $236.22	Professional	26	$61.41	$192.05	$236.22
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $65.20 / $181.13 / $285.88	Professional	TC	$65.20	$181.13	$285.88
Security Health Facility/Professional Professional Modifier Low / Median / High Price $109.43 / $369.73 / $538.75	Professional		$109.43	$369.73	$538.75
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $63.98 / $158.53 / $196.66	Professional	26	$63.98	$158.53	$196.66
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $67.36 / $79.25 / $198.75	Professional	TC	$67.36	$79.25	$198.75
United Facility/Professional Professional Modifier Low / Median / High Price $71.44 / $115.57 / $234.15	Professional		$71.44	$115.57	$234.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.76 / $72.13 / $144.04	Professional	26	$40.76	$72.13	$144.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.31 / $50.60 / $105.74	Professional	TC	$28.31	$50.60	$105.74