Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $108.41 / $108.41 / $206.76	Facility	26	$108.41	$108.41	$206.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.26 / $129.49 / $398.00	Professional		$91.26	$129.49	$398.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.95 / $78.78 / $247.00	Professional	26	$56.95	$78.78	$247.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.10 / $49.12 / $83.27	Professional	TC	$28.10	$49.12	$83.27
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.11 / $162.91 / $590.02	Professional		$83.11	$162.91	$590.02
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.12 / $101.55 / $336.26	Professional	26	$57.12	$101.55	$336.26
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.65 / $61.62 / $204.96	Professional	TC	$25.65	$61.62	$204.96
CareSource Facility/Professional Professional Modifier Low / Median / High Price $40.85 / $88.49 / $200.50	Professional		$40.85	$88.49	$200.50
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $145.08 / $169.54 / $260.08	Facility	26	$145.08	$169.54	$260.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $146.84 / $281.62 / $320.02	Professional		$146.84	$281.62	$320.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.44 / $159.18 / $180.89	Professional	26	$85.44	$159.18	$180.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $62.36 / $122.45 / $139.15	Professional	TC	$62.36	$122.45	$139.15
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $129.41 / $248.27 / $248.27	Facility	26	$129.41	$248.27	$248.27
Medica Facility/Professional Professional Modifier Low / Median / High Price $93.81 / $156.10 / $746.58	Professional		$93.81	$156.10	$746.58
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $61.45 / $103.27 / $352.29	Professional	26	$61.45	$103.27	$352.29
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $31.12 / $49.23 / $288.04	Professional	TC	$31.12	$49.23	$288.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.07 / $63.07 / $188.51	Professional		$25.07	$63.07	$188.51
Quartz Facility/Professional Professional Modifier Low / Median / High Price $164.96 / $227.96 / $317.89	Professional		$164.96	$227.96	$317.89
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $73.73 / $129.41 / $248.27	Facility	26	$73.73	$129.41	$248.27
Quartz Facility/Professional Professional Modifier Low / Median / High Price $163.28 / $449.05 / $746.58	Professional		$163.28	$449.05	$746.58
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $92.29 / $289.20 / $352.29	Professional	26	$92.29	$289.20	$352.29
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $65.72 / $182.57 / $288.04	Professional	TC	$65.72	$182.57	$288.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $300.43 / $456.55 / $667.20	Professional		$300.43	$456.55	$667.20
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $96.46 / $238.85 / $294.45	Professional	26	$96.46	$238.85	$294.45
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $80.72 / $94.96 / $200.23	Professional	TC	$80.72	$94.96	$200.23
United Facility/Professional Professional Modifier Low / Median / High Price $93.48 / $148.19 / $300.24	Professional		$93.48	$148.19	$300.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $59.91 / $100.90 / $216.90	Professional	26	$59.91	$100.90	$216.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.61 / $52.75 / $119.89	Professional	TC	$32.61	$52.75	$119.89