Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.95 / $34.95 / $65.80	Facility	26	$34.95	$34.95	$65.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.95 / $60.30 / $186.95	Professional		$40.95	$60.30	$186.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.98 / $25.10 / $67.55	Professional	26	$18.98	$25.10	$67.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.17 / $36.21 / $61.38	Professional	TC	$17.17	$36.21	$61.38
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.04 / $76.89 / $299.08	Professional		$37.04	$76.89	$299.08
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.29 / $34.77 / $108.40	Professional	26	$18.29	$34.77	$108.40
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.75 / $45.42 / $143.02	Professional	TC	$18.75	$45.42	$143.02
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.96 / $53.70 / $82.38	Facility	26	$45.96	$53.70	$82.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.17 / $140.71 / $159.90	Professional		$73.17	$140.71	$159.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.01 / $50.97 / $57.93	Professional	26	$28.01	$50.97	$57.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $45.81 / $89.76 / $102.00	Professional	TC	$45.81	$89.76	$102.00
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $41.24 / $98.31 / $98.31	Facility	26	$41.24	$98.31	$98.31
Medica Facility/Professional Professional Modifier Low / Median / High Price $44.03 / $70.03 / $351.65	Professional		$44.03	$70.03	$351.65
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $20.47 / $38.86 / $131.37	Professional	26	$20.47	$38.86	$131.37
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $19.72 / $35.86 / $214.27	Professional	TC	$19.72	$35.86	$214.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.71 / $46.43 / $72.52	Professional		$19.71	$46.43	$72.52
Quartz Facility/Professional Professional Modifier Low / Median / High Price $78.72 / $113.59 / $155.78	Professional		$78.72	$113.59	$155.78
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $23.47 / $41.24 / $98.31	Facility	26	$23.47	$41.24	$98.31
Quartz Facility/Professional Professional Modifier Low / Median / High Price $81.59 / $210.05 / $351.65	Professional		$81.59	$210.05	$351.65
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $29.55 / $93.05 / $131.37	Professional	26	$29.55	$93.05	$131.37
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $48.17 / $133.83 / $214.27	Professional	TC	$48.17	$133.83	$214.27
Security Health Facility/Professional Professional Modifier Low / Median / High Price $134.24 / $231.43 / $333.38	Professional		$134.24	$231.43	$333.38
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $39.36 / $89.90 / $108.81	Professional	26	$39.36	$89.90	$108.81
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $50.36 / $59.25 / $148.80	Professional	TC	$50.36	$59.25	$148.80
United Facility/Professional Professional Modifier Low / Median / High Price $44.03 / $71.56 / $138.08	Professional		$44.03	$71.56	$138.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.25 / $36.70 / $65.14	Professional	26	$20.25	$36.70	$65.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.30 / $36.27 / $78.23	Professional	TC	$19.30	$36.27	$78.23