Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $80.34 / $80.34 / $152.50	Facility	26	$80.34	$80.34	$152.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.65 / $102.23 / $199.86	Professional		$77.65	$102.23	$199.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.06 / $55.49 / $189.73	Professional	26	$42.06	$55.49	$189.73
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.35 / $49.50 / $83.91	Professional	TC	$27.35	$49.50	$83.91
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $68.38 / $133.18 / $506.21	Professional		$68.38	$133.18	$506.21
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $42.34 / $79.15 / $249.19	Professional	26	$42.34	$79.15	$249.19
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.65 / $62.10 / $198.79	Professional	TC	$25.65	$62.10	$198.79
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $108.13 / $126.36 / $193.85	Facility	26	$108.13	$126.36	$193.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $126.01 / $241.52 / $274.45	Professional		$126.01	$241.52	$274.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.92 / $118.13 / $134.24	Professional	26	$65.92	$118.13	$134.24
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $62.86 / $123.41 / $140.24	Professional	TC	$62.86	$123.41	$140.24
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $95.51 / $204.09 / $204.09	Facility	26	$95.51	$204.09	$204.09
Medica Facility/Professional Professional Modifier Low / Median / High Price $78.31 / $130.65 / $676.25	Professional		$78.31	$130.65	$676.25
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $46.24 / $84.17 / $271.97	Professional	26	$46.24	$84.17	$271.97
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $30.24 / $49.48 / $290.20	Professional	TC	$30.24	$49.48	$290.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.07 / $62.01 / $186.31	Professional		$25.07	$62.01	$186.31
Quartz Facility/Professional Professional Modifier Low / Median / High Price $146.47 / $194.83 / $271.70	Professional		$146.47	$194.83	$271.70
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $54.38 / $95.51 / $204.09	Facility	26	$54.38	$95.51	$204.09
Quartz Facility/Professional Professional Modifier Low / Median / High Price $140.04 / $374.90 / $676.25	Professional		$140.04	$374.90	$676.25
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $68.48 / $213.35 / $271.97	Professional	26	$68.48	$213.35	$271.97
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $66.23 / $184.01 / $290.20	Professional	TC	$66.23	$184.01	$290.20
Security Health Facility/Professional Professional Modifier Low / Median / High Price $252.05 / $391.69 / $572.26	Professional		$252.05	$391.69	$572.26
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $158.32 / $186.52 / $229.54	Professional	26	$158.32	$186.52	$229.54
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $79.50 / $93.53 / $201.77	Professional	TC	$79.50	$93.53	$201.77
United Facility/Professional Professional Modifier Low / Median / High Price $76.83 / $123.72 / $250.67	Professional		$76.83	$123.72	$250.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.03 / $74.44 / $155.35	Professional	26	$44.03	$74.44	$155.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.47 / $52.82 / $108.02	Professional	TC	$32.47	$52.82	$108.02