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 $71.34 / $104.69 / $392.52	Professional		$71.34	$104.69	$392.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.58 / $58.45 / $220.87	Professional	26	$41.58	$58.45	$220.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.33 / $46.16 / $76.19	Professional	TC	$24.33	$46.16	$76.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $65.97 / $133.05 / $482.74	Professional		$65.97	$133.05	$482.74
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $42.34 / $74.73 / $249.19	Professional	26	$42.34	$74.73	$249.19
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.58 / $56.38 / $178.92	Professional	TC	$23.58	$56.38	$178.92
CareSource Facility/Professional Professional Modifier Low / Median / High Price $37.25 / $75.23 / $162.13	Professional		$37.25	$75.23	$162.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $107.23 / $125.31 / $192.23	Facility	26	$107.23	$125.31	$192.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $119.91 / $229.02 / $260.25	Professional		$119.91	$229.02	$260.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.00 / $117.16 / $133.13	Professional	26	$63.00	$117.16	$133.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $56.84 / $111.86 / $127.11	Professional	TC	$56.84	$111.86	$127.11
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $95.51 / $190.77 / $190.77	Facility	26	$95.51	$190.77	$190.77
Medica Facility/Professional Professional Modifier Low / Median / High Price $74.75 / $121.29 / $622.15	Professional		$74.75	$121.29	$622.15
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $45.25 / $78.79 / $262.07	Professional	26	$45.25	$78.79	$262.07
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $26.70 / $44.76 / $264.17	Professional	TC	$26.70	$44.76	$264.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.07 / $56.50 / $126.60	Professional		$25.07	$56.50	$126.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $135.53 / $185.37 / $258.50	Professional		$135.53	$185.37	$258.50
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $54.38 / $95.51 / $190.77	Facility	26	$54.38	$95.51	$190.77
Quartz Facility/Professional Professional Modifier Low / Median / High Price $132.79 / $359.50 / $622.15	Professional		$132.79	$359.50	$622.15
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $67.93 / $213.35 / $262.07	Professional	26	$67.93	$213.35	$262.07
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $60.04 / $166.77 / $264.17	Professional	TC	$60.04	$166.77	$264.17
Security Health Facility/Professional Professional Modifier Low / Median / High Price $232.47 / $373.54 / $542.60	Professional		$232.47	$373.54	$542.60
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $73.81 / $176.19 / $218.53	Professional	26	$73.81	$176.19	$218.53
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $69.79 / $82.10 / $183.61	Professional	TC	$69.79	$82.10	$183.61
United Facility/Professional Professional Modifier Low / Median / High Price $74.75 / $118.64 / $240.37	Professional		$74.75	$118.64	$240.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.94 / $78.29 / $164.75	Professional	26	$45.94	$78.29	$164.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.54 / $44.76 / $102.31	Professional	TC	$26.54	$44.76	$102.31