Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.34 / $70.34 / $133.33	Facility	26	$70.34	$70.34	$133.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.87 / $95.16 / $306.00	Professional		$72.87	$95.16	$306.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.46 / $54.22 / $141.07	Professional	26	$39.46	$54.22	$141.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.57 / $42.57 / $70.39	Professional	TC	$23.57	$42.57	$70.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.91 / $119.63 / $434.59	Professional		$58.91	$119.63	$434.59
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.06 / $70.34 / $218.17	Professional	26	$37.06	$70.34	$218.17
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.85 / $52.09 / $168.03	Professional	TC	$21.85	$52.09	$168.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $94.62 / $110.57 / $169.61	Facility	26	$94.62	$110.57	$169.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.30 / $207.44 / $235.73	Professional		$111.30	$207.44	$235.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.22 / $103.28 / $117.36	Professional	26	$57.22	$103.28	$117.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $52.83 / $104.16 / $118.36	Professional	TC	$52.83	$104.16	$118.36
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $83.68 / $176.34 / $176.34	Facility	26	$83.68	$176.34	$176.34
Medica Facility/Professional Professional Modifier Low / Median / High Price $68.40 / $116.19 / $568.04	Professional		$68.40	$116.19	$568.04
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $41.09 / $77.31 / $234.92	Professional	26	$41.09	$77.31	$234.92
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $25.83 / $41.84 / $244.63	Professional	TC	$25.83	$41.84	$244.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.07 / $56.76 / $129.80	Professional		$25.07	$56.76	$129.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $125.95 / $167.23 / $233.20	Professional		$125.95	$167.23	$233.20
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $47.55 / $83.68 / $176.34	Facility	26	$47.55	$83.68	$176.34
Quartz Facility/Professional Professional Modifier Low / Median / High Price $120.28 / $322.60 / $568.04	Professional		$120.28	$322.60	$568.04
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $59.88 / $190.23 / $234.92	Professional	26	$59.88	$190.23	$234.92
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $55.91 / $155.30 / $244.63	Professional	TC	$55.91	$155.30	$244.63
Security Health Facility/Professional Professional Modifier Low / Median / High Price $241.88 / $340.06 / $491.50	Professional		$241.88	$340.06	$491.50
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $68.90 / $189.51 / $234.99	Professional	26	$68.90	$189.51	$234.99
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $67.36 / $79.25 / $169.96	Professional	TC	$67.36	$79.25	$169.96
United Facility/Professional Professional Modifier Low / Median / High Price $67.48 / $111.62 / $241.95	Professional		$67.48	$111.62	$241.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.79 / $70.56 / $136.97	Professional	26	$40.79	$70.56	$136.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.83 / $41.84 / $89.30	Professional	TC	$25.83	$41.84	$89.30