Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.65 / $39.65 / $76.06	Facility	26	$39.65	$39.65	$76.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.82 / $65.37 / $109.94	Professional		$42.82	$65.37	$109.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $26.83 / $70.14	Professional	26	$19.95	$26.83	$70.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $41.14 / $69.75	Professional	TC	$19.05	$41.14	$69.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.12 / $84.19 / $314.51	Professional		$43.12	$84.19	$314.51
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.90 / $37.24 / $123.66	Professional	26	$20.90	$37.24	$123.66
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.85 / $51.61 / $160.41	Professional	TC	$21.85	$51.61	$160.41
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.17 / $62.13 / $95.31	Facility	26	$53.17	$62.13	$95.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.85 / $162.13 / $184.25	Professional		$84.85	$162.13	$184.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.65 / $58.92 / $66.95	Professional	26	$31.65	$58.92	$66.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $52.83 / $103.22 / $117.30	Professional	TC	$52.83	$103.22	$117.30
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $47.70 / $97.62 / $97.62	Facility	26	$47.70	$97.62	$97.62
Medica Facility/Professional Professional Modifier Low / Median / High Price $48.03 / $76.59 / $378.70	Professional		$48.03	$76.59	$378.70
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $22.58 / $40.27 / $130.11	Professional	26	$22.58	$40.27	$130.11
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $22.13 / $41.08 / $242.47	Professional	TC	$22.13	$41.08	$242.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.68 / $46.76 / $74.33	Professional		$20.68	$46.76	$74.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $82.14 / $130.94 / $179.58	Professional		$82.14	$130.94	$179.58
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $27.13 / $47.70 / $97.62	Facility	26	$27.13	$47.70	$97.62
Quartz Facility/Professional Professional Modifier Low / Median / High Price $87.02 / $241.74 / $378.70	Professional		$87.02	$241.74	$378.70
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $34.15 / $105.55 / $130.11	Professional	26	$34.15	$105.55	$130.11
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $55.40 / $153.90 / $242.47	Professional	TC	$55.40	$153.90	$242.47
Security Health Facility/Professional Professional Modifier Low / Median / High Price $72.95 / $262.72 / $384.13	Professional		$72.95	$262.72	$384.13
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $39.36 / $88.47 / $108.81	Professional	26	$39.36	$88.47	$108.81
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $54.01 / $63.54 / $168.48	Professional	TC	$54.01	$63.54	$168.48
United Facility/Professional Professional Modifier Low / Median / High Price $49.27 / $76.59 / $158.50	Professional		$49.27	$76.59	$158.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.65 / $36.71 / $78.59	Professional	26	$21.65	$36.71	$78.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.76 / $42.95 / $89.73	Professional	TC	$22.76	$42.95	$89.73