Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.19 / $49.19 / $93.15	Facility	26	$49.19	$49.19	$93.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.53 / $70.64 / $218.95	Professional		$47.53	$70.64	$218.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.78 / $33.65 / $103.00	Professional	26	$25.78	$33.65	$103.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.67 / $41.51 / $68.45	Professional	TC	$18.67	$41.51	$68.45
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.40 / $93.02 / $354.14	Professional		$47.40	$93.02	$354.14
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.92 / $46.04 / $152.56	Professional	26	$25.92	$46.04	$152.56
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.16 / $50.66 / $157.46	Professional	TC	$21.16	$50.66	$157.46
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.68 / $77.92 / $119.54	Facility	26	$66.68	$77.92	$119.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.93 / $172.46 / $195.98	Professional		$89.93	$172.46	$195.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.00 / $72.14 / $81.98	Professional	26	$39.00	$72.14	$81.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $50.82 / $100.32 / $114.00	Professional	TC	$50.82	$100.32	$114.00
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $58.37 / $118.83 / $118.83	Facility	26	$58.37	$118.83	$118.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $53.49 / $84.17 / $398.18	Professional		$53.49	$84.17	$398.18
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $27.79 / $49.26 / $160.04	Professional	26	$27.79	$49.26	$160.04
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $22.01 / $40.04 / $238.14	Professional	TC	$22.01	$40.04	$238.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.04 / $55.81 / $124.70	Professional		$25.04	$55.81	$124.70
Quartz Facility/Professional Professional Modifier Low / Median / High Price $91.72 / $138.83 / $190.40	Professional		$91.72	$138.83	$190.40
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $33.22 / $58.37 / $118.83	Facility	26	$33.22	$58.37	$118.83
Quartz Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $261.70 / $398.18	Professional		$100.00	$261.70	$398.18
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $41.83 / $130.94 / $160.04	Professional	26	$41.83	$130.94	$160.04
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $53.85 / $149.58 / $238.14	Professional	TC	$53.85	$149.58	$238.14
Security Health Facility/Professional Professional Modifier Low / Median / High Price $154.05 / $281.70 / $408.62	Professional		$154.05	$281.70	$408.62
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $91.49 / $107.63 / $132.56	Professional	26	$91.49	$107.63	$132.56
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $54.01 / $63.54 / $165.46	Professional	TC	$54.01	$63.54	$165.46
United Facility/Professional Professional Modifier Low / Median / High Price $54.60 / $86.29 / $176.52	Professional		$54.60	$86.29	$176.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.79 / $45.69 / $91.67	Professional	26	$27.79	$45.69	$91.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.81 / $40.04 / $85.95	Professional	TC	$22.81	$40.04	$85.95