Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.66 / $27.66 / $51.81	Facility	26	$27.66	$27.66	$51.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.86 / $61.17 / $154.02	Professional		$46.86	$61.17	$154.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.55 / $18.84 / $45.33	Professional	26	$14.55	$18.84	$45.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.24 / $42.90 / $102.22	Professional	TC	$33.24	$42.90	$102.22
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.11 / $87.75 / $281.06	Professional		$48.11	$87.75	$281.06
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.57 / $27.46 / $87.82	Professional	26	$14.57	$27.46	$87.82
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $32.94 / $60.09 / $193.23	Professional	TC	$32.94	$60.09	$193.23
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.95 / $43.17 / $66.23	Facility	26	$36.95	$43.17	$66.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.11 / $127.01 / $144.33	Professional		$68.11	$127.01	$144.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.97 / $41.07 / $46.68	Professional	26	$21.97	$41.07	$46.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $45.42 / $85.90 / $97.61	Professional	TC	$45.42	$85.90	$97.61
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $32.90 / $80.00 / $80.00	Facility	26	$32.90	$80.00	$80.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $54.75 / $97.43 / $541.00	Professional		$54.75	$97.43	$541.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $28.39 / $91.83	Professional	26	$16.22	$28.39	$91.83
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $38.29 / $69.11 / $217.68	Professional	TC	$38.29	$69.11	$217.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.71 / $34.06 / $72.58	Professional		$19.71	$34.06	$72.58
Quartz Facility/Professional Professional Modifier Low / Median / High Price $74.40 / $113.63 / $140.81	Professional		$74.40	$113.63	$140.81
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $18.48 / $32.90 / $80.00	Facility	26	$18.48	$32.90	$80.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $73.63 / $250.60 / $541.00	Professional		$73.63	$250.60	$541.00
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $23.83 / $75.34 / $91.83	Professional	26	$23.83	$75.34	$91.83
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $50.72 / $175.25 / $217.68	Professional	TC	$50.72	$175.25	$217.68
Security Health Facility/Professional Professional Modifier Low / Median / High Price $104.22 / $277.43 / $300.89	Professional		$104.22	$277.43	$300.89
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.69 / $65.64 / $79.62	Professional	26	$19.69	$65.64	$79.62
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $108.28 / $152.10 / $197.81	Professional	TC	$108.28	$152.10	$197.81
United Facility/Professional Professional Modifier Low / Median / High Price $53.03 / $94.14 / $192.62	Professional		$53.03	$94.14	$192.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.98 / $26.29 / $55.76	Professional	26	$15.98	$26.29	$55.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $37.17 / $66.54 / $131.44	Professional	TC	$37.17	$66.54	$131.44